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‘Against the Grain and Between the Lines’The ultimate interdisciplinarian, Mical Raz brings her training as a physician and her perspective as a historian to bear on some of the nation’s most pressing health care and public policy issues.By Sandra Knispel
University of Rochester historian, phyisician, cellist Mical RazHEALTH CARE HISTORIAN: An award-winning historian as well as an internist at Strong Memorial Hospital, Raz shares her research expertise and clinical experience to explore how US public health policy shapes health care for Americans, particularly those who face economic and social disadvantages. (Photo: J. Adam Fenster)

The joke would go something like this—a doctor, a history professor, and a cellist walk into a bar. Who speaks first?

One person: Mical Raz. Because she’s all alone.

It’s not every day that a physician teaches in a history department, or that a historian does rounds at a large research hospital. But for Raz, the Charles E. and Dale L. Phelps Professor in Public Policy and Health and a professor of history at Rochester, it’s exactly that. Historian Raz, who is also a board-certified internist at Strong Memorial Hospital, is an unusual hybrid.

Yet, neither career was what she had originally in mind. Plus, there was always music.

“I didn’t go to medical school because I was interested in medicine,” admits Raz. Instead, after high school, like many, she was somewhat at loose ends.

She wanted to study “something humanistic and engaging” but also a science, searching for the elusive “truth out there that I was going to learn.” Raz adds: “I later outgrew that notion. But I thought, ‘I’ll go be a doctor; that’ll be a good start. And then I can figure out what I really want to do in life.’ ”

By most accounts, Raz has a pretty good handle on what she wants to do in life. A physician as well as a noted scholar of the history of public health, she has had a front row seat to the world’s biggest public health challenges in a century. Moving seamlessly between clinic and classroom, she infuses her teaching and scholarship with a grounding in lived academic medicine that’s rare among those who hope to influence public policy. Always on the go, she’s eager to share her perspective to help people better understand the complexities of the US health care system.

“Mical’s energy is extraordinary,” says Theodore Brown, Raz’s predecessor who was the inaugural Charles E. and Dale L. Phelps Professor of Public Health and Policy until 2018. “Even though I have seen her do it time and again, it is still hard for me to believe how she can be such a wonderful scholar, teacher, and colleague and still have what seems like limitless energy for skillful and devoted medical practice, her family, and her engagement with national political issues and the local community.”

video of physician historian Mical Raz playing celloVIDEO FEATURE: An accomplished cellist, Raz studied cello through college and her family expected her to become a professional musician. She still plays the instrument every day.

Born in Iowa City to Israeli parents, Raz moved to Israel with her family when she was 10, a move she describes as “coming home.” From early childhood, music played a central role: relatives and friends, invited for dinner, would turn up with their instruments in tow. After the meal, they’d settle in for some chamber music. For Raz that meant a natural head start. At age two, after a tearful complaint that she was unfairly left out when her older sister played the violin, she got her own instrument—a 1/32 cello—roughly the size of an adult viola.

“It sounded pretty terrible, I am sure, but at least it didn’t squeak like a 1/32 violin because the notes were lower,” recalls Raz.

For a long time, Raz’s family assumed she’d become a professional cellist after decades spent playing in select orchestras, including the Young Israel Philharmonic Orchestra, and performing as a 12-year-old in an orchestra in Moscow’s Red Square.

After graduating from high school, Raz headed to Tel Aviv University where she continued studying cello at the Buchmann Mehta School of Music, along with her rigorous medical studies.

As if time were in endless supply, Raz decided in her second year to enroll in her university’s newly combined MD/PhD program. She had to argue to skeptical administrators that the program’s fine print did not specifically prohibit combining medicine with studies in the humanities—in her case, history. On paper she met all the qualifying criteria, and so the administration, albeit reluctantly, Raz says, agreed to fund her PhD program in the humanities.

“As far as I can tell, I am the first and last student who’s done an MD/PhD program in history at Tel Aviv University,” says Raz.

A dose of reality started to seep in. By the time she started her PhD, she realized that three simultaneous careers were “just insane” and decided to cut back on music rehearsals. But nearly two decades later, music remains an integral part of her life: she still plays cello and practices daily with her children.

University of Rochester historian, phyisician, cellist Mical RazPUBLIC PROFESSOR: Since joining the faculty of Arts, Sciences & Engineering as a named professor in 2019, Raz has taught courses on the history of the US public health system, often encouraging her students to use what they have learned to write guest essays for local media outlets. (Photo: J. Adam Fenster)

Before moving back to the US for a postdoctoral fellowship at Yale University, Raz worked at Tel Aviv Medical Center while volunteering with Physicians for Human Rights. She completed her residency in internal medicine at Yale New Haven Hospital in 2015, followed by a Robert Wood Johnson Clinical Scholars Fellowship at the University of Pennsylvania, before joining Rochester’s faculty in 2019. At Yale she met one of her lifelong mentors, Naomi Rogers, a professor in the history of medicine and a leading expert in the field.

When Raz arrived in New Haven in 2011, she had just won the Pressman-Burroughs Wellcome Fund Career Development Award for her PhD thesis-now-turned book, The Lobotomy Letters: The Making of American Psychosurgery (University of Rochester Press, 2013), which is what initially piqued Rogers’s interest in the would-be postdoc. “The Pressman is a really big deal,” says Rogers.

Yet, Rogers admits, she was skeptical when the young woman talked immediately about starting on her second book. Much to her surprise, Raz returned to one of their next meetings with three chapters already in hand.

“I would assign her more, and she read voraciously,” says Rogers. Raz was already then attuned to the political and cultural underpinnings of medicine, says Rogers. Later, during her time at Penn, Raz brought that awareness to her work on the socioeconomic and environmental circumstances of Philadelphia children and teenagers caught up in the legal system.

Raz, says Rogers, was “head and shoulders” above any postdoc she had ever mentored: “I don’t use that word very often. But she really is extraordinary. She has a determination that helps her to push through while she takes on really challenging questions.” Those who know her speak of her uncanny ability to balance her two jobs and her personal life. “I know it’s a cliché, but it’s true: I really don’t know how she does it,” says Rogers.

While medicine is ultimately the telling and retelling of stories and their interpretation, doctors often say that patients are poor historians, Raz says. She begs to differ. “If anyone, it’s you, the physician, because you’re taking a poor history.”:

As a historian, she says she’s developed an ear for hearing patients’ stories and found that many of her insights come not from high-tech imaging studies or blood tests, but from “sitting next to the patient and listening with an open ear and letting the patient talk.”

Being an outsider and having firsthand experience of different medical systems are part of what makes her work strong, says her former Yale mentor.

Coming from Israel, where generally citizens and permanent residents are covered by universal health insurance, Raz hadn’t given much thought to whether a medical procedure would be covered by insurance or whether the patient could afford medications. Such questions never appeared on her radar before moving back to the United States. But working in a hospital as a resident made her realize that the most important factor about health care is the underlying social system in which it functions. “You can have the most advanced medical technology, but if your patients can’t afford their blood pressure medications, it’s not going to work,” says Raz.

The last two years of the pandemic have been harrowing, she says, not made any easier by the fact that in 2020 she was seeing patients at the hospital while pregnant with her fourth child, worrying constantly about her unborn baby, her patients who had come down with COVID, and about bringing the virus home to her children and husband, Alan.

“It’s been terrifying,” says Raz. “We knew it affected pregnant women severely and there was no vaccine and no treatment. It’s been stressful.”

By the late spring of 2020, she and Alan had begun to talk about what should happen in the event of her death, a scenario that had suddenly moved within the realm of possibility.

She told him to make sure the kids learned and kept up their Hebrew (the kids are bilingual, and Raz speaks to them in Hebrew only), maintained their Jewish identity, and continued to play music.

At times, she admits, she had to dig deep to find empathy for those who in the face of the widening pandemic still chose to remain unvaccinated and in doing so put the hospital staff, Raz, and her own young family at risk.

On the flip side, she will tell you that she loves her jobs, is happy to be able to use her skill sets to respond to the health crisis, and is engaged in work that’s meaningful to her.

Last fall, Raz taught an introductory public health course that examines the US health care system, a topic that arguably has “never been more relevant to students,” she says.

She started the class with a documentary about the 19th-century cook nicknamed Typhoid Mary and segued to the challenge of balancing individual liberties against public infection control measures. The class talked about why hospitals are the centers of care and what happens in a fragmented, unequal health care system. All the topics, she found, resonated deeply with her students.

The pandemic also helped her think through a framework that her Vanderbilt University colleague Jonathan Metzl came up with—dying of whiteness. The concept holds that the US medical system is not only steeped in racist preconceptions and inequity for Black Americans and marginalized populations but is ultimately detrimental for everybody, including white Americans. “These ideas of white supremacy, ideals of individualism, and these fake fears of socialism have led to the fact that in some communities, white Americans have worse health outcomes and lower vaccination rates than Black Americans,” says Raz.

“They’re actually dying of this toxic political ideology. We’re seeing this in many areas of public health and medicine.”

Plenty of academics say that they intend to influence public policy, notes Raz’s Yale mentor, but few actually manage to do so.

“Mical, however, has a strong commitment to being a public intellectual,” says Rogers. The petite Raz, who talks at breakneck speed, writes regular opinion pieces that appear in national outlets such as the Washington Post’s “Made by History” section.

According to Rogers, who has read most of what Raz has published, including many early drafts, Raz’s second book, What’s Wrong with the Poor? Race, Psychiatry and the War on Poverty (University of North Carolina Press, 2013), put her on the national map. A 2015 Choice Outstanding Academic Title, the book has been widely read by US public policy makers, exactly the kind of people whose minds Raz is trying to reach and, ultimately, change.

“I want to make my historical research relevant and influence how people in general—and how policy makers specifically—think.”

The idea for the book started to germinate in 2009 as Raz was finishing up her medical internship in Israel. One day, a colleague told her about the concept of “sensory deprivation” that saw its heyday in the 1960s. At first, Raz discovered, the idea extended just to animal experiments but then hopped from one field to another and was suddenly used to talk about Black children who were struggling at school, apparently “deprived” in their own homes. Raz was appalled.

Even the best-intentioned policies are built on the idea that “there’s something wrong with poor people and starts with the question of how we go about fixing it—rather than asking what are the structures that create poor people, what are their strengths, and how can we lift them up or build on their strength and resilience,” notes Raz. “Asking what’s wrong, which is what we do as physicians, is not a productive or empowering way to approach poverty intervention.”

Ultimately, the realization became her starting point for examining how theories of deprivation have shaped how policy makers think and talk about economically disadvantaged people in the United States.

In her book, Raz argues that mental health professionals, educators, and policy makers in the 1960s agreed on what poor men, women, and children lacked, rooted in psychiatric theories of deprivation. Raz says the deprivation-based concept continues to haunt social policy, profoundly shaping how both health professionals and educators view children from low-income homes.

Raz’s work on the politics of poverty is her most significant contribution to the field to date, says Brown, an expert on US and international public health and health policy, including the World Health Organization. After a 42-year career in Rochester’s history and public health sciences departments, Brown is now a professor emeritus.

“Truly understanding and serving the poor with modesty and respect is perhaps medicine’s greatest challenge,” says Brown. “Mical’s work in the area provides new and strong insights and essential shifts in perspective.”

Today, Rogers considers her erstwhile postdoctoral researcher a “leading historian of health and social justice”—not a small feat for a young academic who has so far published three books, earned tenure, holds a named professorship, and is raising four children, aged one through seven—all before 40.

What makes her so successful is not just her high level of scholarly output but also her strong ability to read original sources “against the grain and between the lines,” says Rogers, who regularly assigns Raz’s book on poverty to her own Yale graduate students.

Raz’s work on politics and poverty continues. Most recently, she turned her focus to the American child welfare system, a theme that she explores in her third book, Abusive Policies: How the American Child Welfare System Lost Its Way (University of North Carolina Press, 2020). Raz details how an overly broad definition of child abuse has become politicized and “weaponized” against vulnerable populations.

“Biased viewpoints regarding race, class, and gender played a powerful role shaping perceptions of child abuse,” says Raz. Coupled with overzealous policies and a belief among the public that serious child abuse is widespread and frequent, “these perceptions are often directly at odds with the available data and disproportionately target poor African American families above others.”

That’s why Raz argues in her book, in her classrooms, at conferences, and in op-ed pieces that many family investigations and subsequent child removals are unjustified and stem from a misguided policy shift that began in the late 1960s—away from supporting families to investigating them and removing children instead.

She’s been sounding the alarm for several years now about the need to keep struggling families intact and to separate children from their families only as the very last resort—and not for reasons of neglect.

“What looks like neglect is often a lack of money and resources,” says Raz. “If parents lose their children simply because they are poor, the system is failing.”

In her classrooms she teaches with the same zest and urgency that runs through her research, asking students to turn their newly acquired knowledge on public health policies into local op-ed submissions.

In the fall semester, she taught a first-year seminar titled Unequal, Unjust: 100 Years of Racism in American Public Health and Medicine, which she says provided “an incredible opportunity” to talk about the pressing issues of the day.

Says Raz, “I didn’t come into this looking for politics; politics found me. And then it opened my eyes.”