Java Tunson, an emergency medicine physician in Washington state, got into healthcare to create a meaningful impact in her patients’ lives—not to take on the systemic racism that permeates the field. But after noticing that underrepresented minority doctors were almost entirely absent in her resident classes, Tunson felt compelled to act. She co-launched a pilot program that significantly increased diversity at her program, and since then, she’s become a go-to leader for minority-related issues. In many ways, though, it has been an uneasy role for her to take on.

“I kind of have a love-hate relationship with it, because I really believe this is such crucial work, and I’m so passionate about equity and justice,” Tunson says. “But at the same time, it’s not why I went into medicine.”

Tunson feels obliged to carry on with this work, though, partly because of a dearth of others stepping up. “I feel like the call to action and heavy work of fixing racism within our system is often left up to minority physicians,” she says. She dreams of a future in which everyone in medicine fights to change the system for the better, allowing her to focus on clinical and academic interests, and on her other great love, art. “The ideal,” she says, “is that this wasn’t an issue I had to work toward.”

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In a family of teachers and artists, Tunson, who split her childhood between Colorado and Switzerland, is an outlier. When she was a kindergarten student, she announced that she wanted to be a brain surgeon. Later, she thought she wanted to be a pediatrician. She eventually settled on emergency medicine because of the complex, high-stakes problem-solving it entails. She also values the chance to help people when they are at their most vulnerable. “I just really have a deep love for humans and what they go through, and the truths that we all encounter,” she says. 

Tunson credits her powers of observation and deep humanity in part to her father, Floyd, a professional artist. She remembers spending hours in her dad’s studio, for example, poring over intimate portraits of people he’d photographed in the Mississippi Delta in the 1970s. She also seriously pursued drawing and painting through college and even managed to employ her photography skills at medical school to create a breastfeeding campaign.

Dr. Tunson and her father Floyd. Credit: Tom Kimmell

“Mastering medicine is kind of the same as mastering art: repetition with constant variation and pattern recognition,” Tunson says. “There’s an emotional intelligence that has to be there, too.”

After completing medical school, Tunson was elated to match with the Denver Health Residency in Emergency Medicine program. But she was bothered to see that she was joined by only one other underrepresented minority resident, Dowin Boatright, who was a year ahead of her. Together, Tunson and Boatright, with the support of several faculty members, decided to start a diversity group aimed at improving recruitment and representation of minority residents. They undertook a multi-pronged approach that included reaching out to minority graduates to increase the program’s visibility, creating a scholarship to help potential candidates visit and meet the community, and adjusting the way that the decision committee considered applications. For example, faculty members on the diversity team wrote letters of support for underrepresented minority candidates and were present in meetings in which their rankings were discussed.

In just a year, the percentage of underrepresented minority applicants invited to interview doubled, and the number of enrolled minority residents increased from just one in 2011 and 2012 to four in 2013. Tunson and Boatright published the results of their pilot program in Academic Medicine, and from there, Tunson says, things snowballed, including presentations at major conferences. A few years after Tunson moved to Seattle to begin her career, the American College of Emergency Physicians invited her to be the chair of the Washington chapter of the group’s anti-racism and health justice committee. She accepted the role and now works to combat systemic racism in medicine, including by educating doctors about how biological racism and implicit bias can seriously impact patient care, morbidity and mortality.

Tunson considers these activities to be imperative and life-saving, but at the same time, she laments the fact that this type of work has to happen in the first place—and that it almost inevitably falls on minority physicians to carry it out. “It’s 2021, and it’s just really tragic that we’re still having to have these conversations and that some of the conversations seem new, but they’re not,” she says.

Between her social justice work and full-time job as a physician, Tunson doesn’t have much time these days for art. But she hopes to eventually find her way back to it—perhaps even drawing inspiration from the ER. “Being such a visual person, there are moments in my day when I can pause and think, ‘Oh wow, this would be a stunning photograph or painting,’” she says. “I just think it’s such beautiful material.”