Black History Month Member Interview: Larry Charleston, IV, MD, MSc, FAHS

March 2, 2023

Larry Charleston, IV, MD, MSc, FAHS
Professor, Director of Headache & Facial Pain, Director of Faculty Development
Department of Neurology & Ophthalmology
Michigan State University

Q. Please tell me about your career, path, and research.

A. One might say that my career has a little non-traditional. I was an athlete in college and knew from the fifth grade that I wanted to be a neurosurgeon or a neurologist. While I didn’t take the neurosurgery path during medical school I completed my neurology residency, a headache fellowship, worked on the US Capital for a year, and then began working at a private/academic/teaching hospital. I then moved to the University of Michigan where I was the first African American faculty member of the Department of Neurology, to my knowledge – and that came with different opportunities and challenges. I was faculty for nearly 8 years. At the University of Michigan, I learned about mixed methods and community-engaged research. That was critical for my research career as I had done a few different research projects, including college level basic science in high school. While that was very cool and I was good at it, I did not have a strong passion for it and did not see myself doing this as a career. Actually, having a strong research career did not come to my mind at all. But it was cool, science fairs and all that type of stuff, I kind of geeked out on science. Many of us as neurologists, well, we're nerds right? I recall some of my classmates and teammates (I was a three-sport athlete) in high school would say, you’re a nerd man, but you’re a cool nerd. So, I take that I’m a cool nerd.

Anyway, I learned a ton doing basic science, expressing human centromere protein in drosophila melanogaster cells, but as I said, did not see myself doing this long term. At the University of Michigan I was able to learn about mixed methods research, learn about community engaged research which has sparked my interest. I love being out in the community, I love being able to really connect with people. I did a master’s program while I was working at the University of Michigan, and that's where I really began my research career. In 2021, I began my tenure at Michigan State University College of Human Medicine, and am now the director of the Headache and Pain Division and Director of Faculty Development, in the Department of Neurology and Ophthalmology. I am also working to strengthen our department’s research infrastructure. I am still very partial to community engaged research, especially with research with underserved and under-representative populations. Currently, I have an ongoing study developing text message interventions for migraine with the African American community. In addition to research, I’ve been involved in health policy and have been honored to serve in varies leadership positions. I am still serving patients, hopefully serving my faculty and community here at the university, but also trying to get out there and reach out there with people in the in the community, the broader community to see how we may accomplish great things together.

Q. What elements of diversity, equity, and inclusion are most important to you and your career?

A. I'll share two. The first is “what is inclusion?” So many arenas I've been a part of, I've been the only one that looks like and sometimes really kind of thinks like me. Sometimes the cultural experiences are different with different ethnicities and different backgrounds. The majority of my career, I've been in those rooms where it's just been that I’ve had to learn to adapt, be culturally sensitive to other cultures – yet so many times that was not reciprocated. There was almost an expected cultural assimilation on my part– assimilating to someone else’s culture. I’d like to see that there was a little bit more inclusion.

I've done a lot of diversity, equity, inclusion talks, and sometimes I use the analogy; diversity is being invited to the party, equity is that you are being provided a table and served something at the party and inclusion is that people dance with you – and then there is also the concept of belonging, belonging is when the DJ plays your music.

I understand that the tenet of belonging was not asked in the question I’m answering, but a sense of belonging is important to me.

I've heard it said that when focusing on and implementing inclusivity, you'll get the diversity part just by being more inclusive. And then there’s equity. I also believe that people should have equal opportunities, I don't necessarily think that it's going to equate to equal outcomes, but I do think that people should have equal opportunities.

There are clearly things in medicine that are not as equitable as we would like it to be or as I would like it to be.

Q. What's the best career advice you've received?

A. It's a tough question, because my career advice has changed as my career has changed and morphed, the best advice that's changed and morphed over seasons of my career. I think to boil it down, it is: If you want something, go after it.

Now there's a lot of ways to go after things, there are some that are more intuitive than others, there's some that are harder than others, there are times where one doesn’t necessarily need to reinvent the wheel - having great mentorship to guide you throughout the process. I’ve had different mentors through different seasons of my life.

When I say, if you want something, really go after it, I mean obviously using ethical means. Another key advice is to seek and pursue knowledge, wisdom and mentorship.

Q. What does Black History Month mean to you?

A. It means a lot. I feel like. Unfortunately, this society has been plagued with the ills – has had discrimination, has had slavery, has had instituted laws of inequity and institutional policies like Jim Crow laws, things like that, so that the way that some people view other people has been a little bit tainted and quite often biased – there is definitely room for improvement in our perspective of one another. So Black History Month is a time to remember those who have paved the way who have been overlooked, sometimes do not even get recognition, and oftentimes did not get recognition in their day for what they were doing. Black History Month is a month that people become a little bit more cognizant of individuals, and just really looking at individuals that have done things. I think it should be ingrained in our society on a daily basis, where we have acknowledgment of those that have truly made differences and strides in our great nation. We have a great nation - there's no doubt about that. At the same time, I think there's things that we need to work on, I think that Black History Month puts a focus on some of the achievements and some of the struggles of people of color in this great nation. It is also a time to remember and learn Black history. We don’t live in the history, but understanding the history, so history doesn't repeat itself and we can become a better, more unified nation, I think it's very important.

Q. Who is an inspirational Black historical figure that inspires you, and why?

A: Two historical figures come to mind --
Paul Robeson and Dr. Benjamin Carson. Paul Robeson was an athlete, scholar, artist, and political activist. Then I’ll also say Dr. Benjamin Carson, I’m from Detroit - he's from Detroit. I read his story. I had the opportunity to meet him on a couple occasions; once when I was a senior in high school where I told him I was going to be a neurosurgeon; and another where I was able to speak with him at an SNMA meeting and remind him of our first meeting when I was in high school. He was very inspiring to me and continues to inspire me. People have their different thoughts but one can't deny what he has done and his actions speak as far as what he's done for the field. I also think of Dr. Alexa Canady who was a pediatric neurosurgeon at Wayne State.

Q. What can professional organizations like the ANA do to support the advancement of Black physician-researchers and scientists?

A. I think there's a lot. First of all I think that one of the biggest things that we need to do, that organizations need to do, is really work on pipeline. There are different ways to look at pipelines. Are you looking at pipeline from the sense of the students that are coming up? Are we highlighting Black physician-researchers and neuroscientists and making them accessible to the next generation? You can't be what, you don't see, whether you see it in your mind's eye, you see it in your visual eye. If one doesn't see themself in something it’s very unlikely that they will become or do it. Rising Black physician-researchers and scientist need to see others of similar background in leadership and key organizational/decision making positions. I think organizations themselves need to show it is not just talk, it’s show not just tell. Support of advancement of Black physician-researchers and scientist is in how we act, and how we respond to each other, and how we treat each other. Organizations need to move beyond just having a DEI statement and act on diversity, equity, and inclusion initiatives.

So, I think one of the things we can do is be the example - have a focus on leadership, have a focus on pipeline. Pipeline can go as far back as people are students. Trainees in medicine may experience struggles and obstacles that people prior to them, or prior to the stage they are in, have experience. Organizations can seek to discover and mitigate such challenges for those in the pipeline at different stages. If organizations can make themselves more diverse in thought and more transparently inclusive, and increase awareness of what we are doing and who is involved, who is at the table of decisions and making them – I think this would support the advancement of those underrepresented in medicine and these are things that organizations can do. There are some subtle things, too, like websites, what do people see when they go to a website.

One of the challenges is that there are fewer in the underrepresented space which makes them under-represented, and they may not necessarily have the masses for a movement as seen in other movements in medicine. We also want to make sure that that people are not getting what we call diversity tax. This needs to be something that's intrinsically woven into the fabric of our society, and for societies in general. Really avoiding diversity tax. We can avoid inappropriately using the word race. Last I checked, there is one race, the human race. We can stop using the term minority, if you noticed, I have not used this term during this interview. Minority means lesser - there is nothing empowering about that term. We can lose that term from our vocabulary, awards, programs etc. We can use terms such as, under-represented, or perhaps marginalized, minoritized individuals, and/or derive better terms that are more empowering to individuals of various and diverse backgrounds. There is a different between being a minority and being minoritized. Even small changes like that are important and can make significant differences in how people feel accepted and in a growing organization.

This interview originally appeared on the American Neurological Association website.