By JEFFREY FLIER, MD (5)

The walls were entirely bare. Thirty-one oil portraits of medical and scientific leaders that had made the room distinctive were gone. Images of Harvey Cushing, Soma Weiss, George Thorn, Eugene Braunwald — and other historic figures — had been removed.

I’d been to the Bornstein auditorium of Brigham and Women’s Hospital many times during 40 years on the Harvard Medical School faculty and nine years as its dean. But when I arrived in the early morning several weeks ago to lecture to the hospital’s storied department of medicine, I was startled upon entering the familiar venue.

A year earlier, The Boston Globe reported that the portraits would be removed as part of a diversity initiative, but I hadn’t seen the result. What I experienced was not diversity, but sterility.

The room was empty, and I snapped a photo of the bare walls. As the audience assembled, two senior professors greeted me. When I queried them about the missing portraits, both seemed uncomfortable. Loss of the portraits was sad, they said, but looking around to ensure they weren’t overheard, they said discussion was “no longer possible.”

After introduction by the chief resident, I delivered my lecture, the bare walls a constant reminder of the missing portraits. Later that day my reaction.

The response to the tweet was mixed. Some praised me for my “bravery” in addressing this, while others suggested I should have been more sensitive to the unwelcoming environment the portraits created for some in the community.

Why should this be? Today’s Brigham is increasingly diverse with respect to gender and underrepresented minorities, but nearly all the portraits were of white men.

The gap between portraiture and current workforce was obvious, and addressing it fell to Brigham’s CEO, Elizabeth Nabel, a physician-scientist who had trained in medicine and cardiology at the Brigham 30 years earlier. She concluded that removing the portraits would foster a more welcoming environment for the increasingly diverse community of employees, students, trainees, and faculty. And then — overnight — the portraits were gone. Some were redistributed to other, less public, locations, raising the question of how such relocation would promote diversity or create a more welcoming environment.

Reactions to removal of the Bornstein portraits varied. Some who couldn’t decouple the portraits from prior exclusion of women and minorities cheered.

Others supported the portraits as a means to recognize past accomplishments, despite the subjects living at a time of limited opportunities for women and minorities. But voicing such views today is not without risk. As I discovered on Twitter, discussion is less likely when those questioning the change are probably going to be characterized as members of a white patriarchy indifferent to concerns of women and minorities.

My tweet inspired discussion and reflection. I concluded that, despite some valid concerns, removing all the portraits from this historic amphitheater — in this way — was a mistake. Celebrating diversity doesn’t require erasing or suppressing the memories of those who contributed greatly to the institution and the profession — people whose work continues to have impact today.

This issue is not restricted to the Brigham. In Harvard’s historic psychology department, portraits of its founder, William James, famed psychologist B.F. Skinner, and other leaders were removed for similar reasons. Such events have broad cultural significance.

Institutions commission portraits to acknowledge past contributions and to narrate institutional history, and their public display highlights important issues. In this case, American medicine — and medicine elsewhere — was for much of its history largely closed to women and minorities. The first women were admitted to Harvard Medical School in 1945, and the first woman was appointed full professor in 1946. Black medical students were few in number until 1968, when faculty pressure happily produced a sustained effort to increase their numbers.

But display or removal of portraits doesn’t change history or current practice. The latter requires culture and policy to evolve. Brigham and HMS now aggressively seek equal opportunity for women and minorities, reflected in broadly increased participation by students, residents, faculty, and CEOs. Women represent half of entering medical students and lead programs and departments throughout the school. Underrepresented minorities have also advanced, though their numbers are smaller than their share of the population, so more remains to be done.

We should seek to learn from this story of substantial progress — rather than hide it from view.

Some wish to judge those who lived at a time when different values prevailed, but this is hardly straightforward. Unlike disputed portraits and statuary related to slavery and the Civil War, these men made contributions to medicine and research that stand up well to current scrutiny. Early in Brigham history, actions of single individuals wouldn’t have diversified the workforce — that required major shifts in societal values. More recent leaders played essential roles in promoting today’s more diverse community.

History and context matter, and should be accurately communicated in any effort at portrait renewal.

Removing all the historic amphitheater portraits — leaving bare walls in their place for the past year — won’t advance diversity. What might? An array of art that reflects today’s rapidly changing physician leadership, while recognizing essential but less male-dominated health-related professions, such as nursing and social work.

Perhaps a rotating subset of older portraits displayed alongside newly commissioned works — with the reasons for the choices conveyed in historically informed commentary. As images of women and minorities join those of past leaders, the divide between limited past diversity and the more diverse present would diminish. And importantly, newly configured portraiture could provide an essential lesson: that diversity and inclusion are hard-won victories that should neither be hidden nor taken for granted.

Gender and ethnicity must cease being barriers to positions and recognition. As that day approaches, public portraiture should be reconfigured to promote pride in institutional history, education about the difficult path to progress, and a welcoming environment for today’s diverse communities.

Jeffrey Flier is a professor of medicine and the former dean of Harvard Medical School. This post was first published on STAT News.