Black History Month Member Interview: Charles C. Flippen II, MD, FANA

CFCharles C. Flippen II, MD, FANA

Professor of Neurology

Director, UCLA Neurology Residency Program

Ruth P. Walter Chair in Neurology

UCLA Health

 

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

A. Like many physicians, I had a set of parents who were encouraging me to be a doctor, and the brainwashing started at a very young age with cereal doctor kits for Christmas, candy medication, the little plastic triangular reflex hammer, all of that. I knew from early on what I really wanted to do, and I think that my personality sort of lends itself to being a physician. I feel best when I’m helping people, I'm curious and I think that those are qualities that really fit well with being a physician. I entered medical school with the intention of being a pediatrician. I had never encountered or really heard of a neurologist. I modeled myself after what I had seen growing up. We had a strong community of Black physicians in Flint, Michigan, where I’m from, and my parents knew many of them, through church and social organizations, so they had a big influence on me. In medical school at the University of Michigan, following the first year, I did research in phantom pain with a neuromuscular sub-specialist, Dr. Mark Bromberg. He took me on consult rounds with him, and that's when I was first was turned on to neurology, The patients had really interesting stories, and examining the patient was really central to how he would figure out what was going on. I, like many in neurology, I really love our examination and everything that we can learn from it, to figure out what's going on with a patient.

During my fourth year in medical school, I completed a sub-internship in pediatric cardiology. I have a soft spot for children; sick children really tug on my heart, and so that was just difficult emotional experience and could not see myself dealing with those circumstances daily. I thought of child neurology, but it didn’t resonate with me. My consult elective in neurology really sealed the deal for me. More stories, more interesting findings and disorders. That's how I decided on an adult neurology. For residency, I interviewed at a lot of programs, I decided to go to University of Maryland because it was one of the few programs that had people like me in training, and not just within neurology, but across the entire hospital. Pretty much every residency program had Black residents and it was a different feel. It was in Baltimore, with a large Black community. I really felt at home in that program. The faculty there were great teachers! Ken Johnson, the chair at that time, was very supportive of all the residents. We did poke fun at him because he was such a great researcher, he was always traveling and speaking, and he would say, “My door is always open,” but then we would say, wait, but he's not there. But he was there. We could always arrange to meet with him, you felt that he knew you and would have your back. It was a great experience for me.

I decided on headache medicine as a subspecialty because it's a subspecialty that spans generations. I have older patients, or if I choose, I can see adolescents, even children. In my first faculty position at Indiana University, I consulted at the Riley Children's Hospital. I have the ability to see patients across the entire spectrum, and that's really afforded me a satisfying clinical career. I did not have the intent of entering academics when I graduated from medical school or upon finishing fellowship. I had signed with a practice outside of Atlanta, but my then girlfriend, soon to be fiancé and now wife had a fellowship at Indiana University. We had been separated during residency. She did her residency in Michigan. I was in in Maryland. Following her, I decided to look around Indianapolis, and on the advice of my fellowship mentor, Dr. K.M.A. Welch, spoke with Jose’ Biller, who was chair of neurology at Indiana University at the time; and Bob Pascuzzi who was the vice chair. They didn't have a headache medicine subspecialist; I think this was just at the cusp of headache medicine really being something sought after in academic departments. I interviewed and four days later, they offered me a position. So, I said, “okay, I can do this,” and my wife was at the University in fellowship, so we could have lunch every day, and it worked out. I found that I really enjoyed teaching. I had done it as a resident and had leaned into it. I thought I was pretty good at it, and I got a lot of positive feedback. Thinking back on my own experience, I didn't have a lot of professors who looked like me throughout my schooling. There were a few Black students at in Indiana University who had reached out to me for advice, and so I thought, it’s good that I’m here. That's what charted my course in academics, and thus far my career has focused mostly on education. I've been a clerkship director; I’m ending my time as a residency program director at UCLA this year. Now I've taken on a new role at UCLA as the as Associate Dean for the Center for Continuing Professional Development, the last area of medical education that I haven’t put my hands on. I’m looking forward to the challenges here because it's a space that we spend most of our careers in, I see a lot of opportunity for making some meaningful innovations in delivering valuable content to our community of physician across medicine. I’m excited about the opportunity!


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

A. I think equity because I think it's foundational to the other two words in DEI. Without equity of opportunity, you don't have an opportunity to be inclusive, or to build diversity within the field. I've been fortunate to have mentors and sponsors along the way who have given me the opportunity to do things, to lead, and really having opportunity, has been pivotal for my career. We're in such a fraught environment now with the divisions that we see within society. I think a misnomer has been the concept of affirmative action, it's actually affirmative opportunity. People get opportunity, the opportunity where it did not exist, to pursue their goals. You are given an opportunity, no one gives you the grades, no one gives you the degree, you still must meet all the metrics that are set forth. You just get an opportunity to do that, and that opportunity had been denied for centuries, and so it's all about equity. People think that the guys peering over the fence of the baseball field is so somewhat of a trite example of equity. But really, it's true. You need to take under consideration what have people experienced that brings them to that point, to where they they're going to have an opportunity and still have to meet the same metrics for success. No one’s being given anything, other than an opportunity, which we all should have, to pursue our goals. I think equity is the foundation. When you're given that opportunity, you should be an environment in which you are able to thrive and that's where the inclusive part comes in. That was the normal experience in prior generations. You may have been given an opportunity, but then you were shunned and obstructed.. That's not going to allow person to be successful and while it's not as onerous today, we still have many spaces where that inclusion is lacking. If you have a foundation of equity, and you create/maintain an inclusive environment, the diversity is more likely to be sustained. Seeking a physician workforce that reflects our communities needs to be an intentional vision particularly to redress our society’s mistakes of the past, you have to have that vision, but at the core it starts with equity.


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

A. The advice didn't come in the context of career, it's something that my father told me:” You can learn something from everyone. “That has really colored the way I approach every day. I listen, because to learn, you really have to listen. I try not to talk too much; I like to spend most of my time listening. I think having that mindset, everyone is a teacher, whether that's the person who delivers my mail, our medical students, my residents, my colleagues, my patients - I learn something every day. I think that is really what keeps me going is the fact that every day is different in that I usually encounter somebody who in some way shape, form, or fashion, forces me to examine some belief I have in a different way, so that I’m constantly growing. 

My dad exemplified that - I could take him anywhere and he could find people to talk with. When I was a fellow, I presented a poster at the Migraine Trust in London. I took my dad with me, and he was all excited, you know, going to Europe, an international trip. So, I’m at the conference, and he spent a day exploring. He found his way to University College of London, when I caught up with him, he was in a cafeteria, and was talking to some students who were Eritrean. They had just gained their independence, and he's just holding court asking questions about how excited they were about their new country, That was just kind of guy he was, you could put him anywhere, and he could strike up a conversation with anyone.  He really imparted this notion that talking to people and listening, it really enriches your life.


Q. What does Black History Month mean to you?

A. Two things. First, it's an opportunity to really reflect on our journey in this country and also to honor the stories of the people whose shoulders we stand on - both their struggle, and their achievements. There is also the second part of it, it's a challenge that we all have to author a narrative of our country that takes into account the importance of all the people who have contributed to this messy, imperfect path that has resulted in what I think is the best country, for opportunity, in the world. It's not a straight path and not acknowledging all aspects of our Nation's history works to our detriment, because we make the same mistakes over and over again. It's not a matter of minimizing or exalting one group over another. We should be able to have a narrative of our country that is as objective and inclusive as possible, that recognizes there are a lot of people who contributed to the successes that we've had as a nation, and that we've got some things that we still need to work on. The divisions we have regarding our national narrative are holding us back now. Learning the painful parts of our history are as important as celebrating the successes if we are going to make genuine progress


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

A. I'm going to cheat a little bit and say two figures, both are inspirational to me, for different reasons. Frederick Douglas because of his dogged self-determination, his persistence at a time where he was a singular voice, and he was fearless. If you think about the nineteenth century, an escaped slave who put himself front and center in the fight to end slavery and gain full citizenship. There are a couple of quotes of his: “If there is no struggle, there's no progress,” and I think that many times people seek to move ahead without any discomfort, and that's just not the way a society operates. There's always going to be struggle, and he embraced that struggle and then: “Power concedes nothing without a demand. It never did, and it never will.” Those two quotes have been inspirational to me. The demand for equity must be clear; it cannot be equivocal. That being stated, it doesn't have to be a threat, but it must be clearly and firmly stated. I think that people conflate clarity and being definitive with aggression. They are not synonymous. You must be clear and definitive in how you want to see change in the world. Douglass was a great exemplar of that philosophy.

And then Dr. Charles R. Drew, who advanced techniques for blood storage and developed large scale blood banks.. There was a Black mortuary in my hometown that would sponsor Black history calendars. They would have for each month a graphic cartoon of a seminal figure in Black history. I looked forward to every January because at my church there were free copies of these calendars, and I would read them. I still have them from the 1970s, somewhat dog-eared. I discovered Dr. Drew in those calendars and his story just spoke to me. He was a renaissance man, he was two-sport varsity athlete, he was at the top of this class. He not only became a physician but also trained a generation of surgeons and taught at Howard University. He persevered and led. I just thought that if I could be a tenth of what he was, well that'd be great. His story was one that was always in my head as a kid.


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

A. Well, first, I want to acknowledge the efforts the ANA has already made. The ANA today is much different than the first meeting that I attended. I think that there are a few steps that could be made; engaging with the historically Black medical schools (which I know the ANA is already doing with one of them), really leaning into for opportunities for faculty mentoring, and then building pipeline programming within the neurosciences. Historically, I think those institutions have seen themselves mostly as producing primary care physicians, and I think there's an opportunity to really make inroads in producing neuroscientists, clinical neurologists, neurosurgeons, and psychiatrists. I think continuing to give leadership opportunities within ANA to a diverse pool of young people. I think it's incumbent upon all of us as we progress through our careers to look back at the people behind us and know when it’s time to let the next generation step up. And really lean into mentoring. I think that the ANA continuing to be intentional in broadening the pool of people who have opportunity to lead within the organization is essential. Additionally, supporting and advocating for increased funding for community-based clinical research, which is an area that many Black clinical neuroscientists have an interest is vitally important. We have the Institute of Medicine report about the disparities in care, that’s now 12 or 13 years old and we still haven't made significant inroads in mitigating those disparities. Valuing that research (its real research, not just community engagement!)  and investing in it is key to the health of not just marginalized communities but to the nation . That’s an area where within neurology we could have a significant impact. We need to invest in young investigators and ensure that they have the resources to be able to do that work at a high level.

I would like to thank you and the ANA for pursuing this endeavor, hopefully, not just in the month of February, but at other times during the year as well.