In the latest edition of the Yale Child Study Center (YCSC) “On Leadership” blog post and newsletter column, Daryn David, PhD shares part two of an interview with James P. Comer, MD, MPH. In the first portion shared in October, he talked about how his early life experiences laid the groundwork for his leadership practices – in part two, he brings his past experiences to light in the context of today, and the future. The transcription from the recorded interview has been lightly edited, including with the occasional insertion of square brackets to indicate a turn from verbatim transcription to summarization. Dr. Comer serves as the Maurice Falk Professor of Child Psychiatry at the Yale Child Study Center. The interview was conducted live on September 26, 2023 – the day after his 89th birthday. Daryn David (DD): What about in our context now? What would you say during your tenure here have been the biggest shifts in leadership, and what do you think that has brought for us?James Comer (JC): Well, I'm not sure. I have mixed feelings actually, because for the most part, we didn't have, in the old days, nearly as many meetings, nearly as many things that I understand must go on – training and planning – people left me alone and I did my work. You can't do anything about that. I think it's a part of size, and that the world has just become a more complex place.I understand. I understand it has to be done. I think Linda [Mayes is] remarkable because she seems to be on top of all of it. Those emails that come at hours – I don't know where you get the energy to do all that. Anyway, that's what's happening. The complexity of systems is such that I don't know how we can keep up with that.DD: What about the role of diversity? By that, I mean gender, race, ethnicity, religion – whatever we want to talk about – what do you see as the importance or the relevance of that for leadership going forward?JC: I think it's very important, critical. I do have mixed feelings. We are addressing issues that should have been addressed long ago. I get mixed up in my thinking about when and how things changed; and about when and what changes are most effective, and how to help bring them about. I think I saw the first deep and real change in the '60s. That was really the first time that a white male-dominated society was challenged about anything. It was also the first time the race issue had to be reckoned with, as a nation, with more than suppression and avoidance. It had never happened. There had always been a way to rationalize and justify injustice. Those being denied had to endure. The strategy that I grew up with was that you just keep going as best you can but you keep pressing for what you're entitled to. You fight when you have to, but you can’t prepare yourself and help bring about better conditions if you are totally caught-up and injured in an endless battle. You keep pressing and preparing to help bring about needed change.DD: What if people are systematically not giving you what you deserve because of race?JC: When you don't have the power to do anything about it because you're too small in number, and the system is so well supported in what it's doing, you can scream all you want to and it's not going to change. You'll just lose your ability to make any movement at all, which was [how it was] until the '60s. That's the way it was, literally. That's what my father meant when he says, "Prepare yourself. Your time will come." This will change, but right now, you better develop the capacities you need to help bring about change. Create your own opportunity ladder and extend it to creating such a ladder in the communities around you and the society.DD: That hurts me – it’s a painful thing to hear. That there was no room. JC: Well, we’ve never had a democracy – a full democracy. Democracy was hijacked from the beginning and there was no way to challenge it – enslaved Africans had no power, and no allies, and…African Americans were the designated scapegoats. There was just nothing and nobody to turn to; except us. Many developed within our community a kind of personal excellence commitment and a positive group identity in the face of a society that was sending the opposite message. There was an effort to hide African-American success. When I was at the Howard University College of Medicine, the host of one of the local morning talk shows talking about medical school appreciation week said, "We (Washington, D.C.) have two fine medical schools.” But there were three. He left out Howard. We didn't exist. Successful African Americans didn't exist was the message.We didn’t have the power to undermine the effects of abuse, neglect and exclusion. In pervasive, subtle, and sometimes violent ways protest and protesters could be and were crushed…and it was over. And many if not most didn’t even know, or denied, that there was pervasive crushing going on.But continued pressure for inclusion, economic and social needs in the society eventually led to what I call the three breakthroughs--the racial integration of the army or military, baseball and Jackie Robinson, and then school desegregation. Inclusion pressure broke down these major messengers of inferiority and supremacy. With successful performances and outcomes, the pace of inclusion began to quicken. Also, science and technology made irresponsible race related exclusion behavior visible – and exposed it as hurtful to all, not just the excluded. It has become more difficult for the forces of racism, but these forces are still living and loud.The economic and social changes that can give full democracy a real chance can and must now be fully addressed. That calls for more effective efforts to enable ALL families that support the development of ALL kids to function well; for schools and all support systems to function well. And it calls for recognition of and overcoming of the past ill-effects of abuse, neglect and exclusion. Inclusion, preparation for life in families and education, and democracy and freedom are inextricably linked. Support for effective family functioning and child development, and through education in particular is where the preparation must take place. This calls for responsible behavior and performance from citizens to policy makers and practice leaders. One of our American problems is that we have taken our right to freedom very seriously, even frivolous freedoms, but responsibility to support our own needs and democracy not so much. There's much in our founding documents about freedom, but responsibility not so much. In my area of work we're trying to get teachers and administrators and all to help kids have experiences from the very beginning that will help them want to be successful achievers and responsible people and citizens, and gain the motives and skills to be promoters and protectors of a full democracy .DD: We just walked in very honest but also painful terrain. I want to end on a more upbeat note, if that's okay. What success as a leader are you most proud of?JC: Well, most of all…I was involved in helping people who thought they couldn't succeed – and they did, or did much better; not in one area of responsibility, but in all the areas I've been involved in. The school program outcomes, the honorary degrees have come from enabling schools to do what they thought they and most others thought they couldn't do. I was an associate dean for the medical school for a long time. A few students even credit my presence and support for making it though medical school and for contributing to their own very successful careers. Several have become appreciative lifelong friends. A couple of them got to me yesterday [on] my birthday –and recently. Also, I got a letter or email during my birthday week from a white couple from a deep South state. I hadn't heard from them in 58 years. I worked with them during my second year as a resident psychiatrist. He thanked me and pointed out that 58 years ago he and his wife were about to split up and Yale sent them to me for treatment. They made it not only that year, but 58 years. It's those things in my life that have been very important to me. And I’m proud of my effort sharing my head of household role with my wife, kids, family. It's kind of on all fronts that I feel that I've made a contribution by doing my best to do what the tasks call for. It’s interesting too that it's very much like what my parents did.It was a long time before I realized that my parents were remarkable. I thought they were simply doing what all parents do. I think many people just forget the support of parents; that self-made success is truly rare, if ever. This contributes to the society not adequately focusing on and supporting family functioning and child development. Though my career I have led an effort to not only remind us, but to call attention to the relationship of development and well -functioning to a well-functioning democracy. DD: What would be your hope for leaders who come after you in terms of carrying forward your legacy? JC: The same notions. I want to care about and adequately look out for myself and family and make a difference for others and the society. I want to be respected and I want my basic rights protected. I want to be cared for and about. I hope leaders of all kinds and at all levels can support and model these notions and beliefs. Everybody should have a threshold above which they're almost certain to be able to live. Society has a responsibility to help make it possible for all to help all make that happen for all. That's what I want to see – what I hope I'll see. I'm very impressed with the caring and work of a lot of young people who are coming along right now…but whether we can make it happen in time is a big question. DD: In time for…?JC: Yes, we're facing what could be catastrophic conditions in our society and in the world. Responsible leadership is critically needed.DD: The rain we just had for three days, everything.JC: Yeah…and more. Some huge threats could have been avoided and now it’s not clear how we can overcome their ill effects. If leadership on all fronts can get us through this next 10-20 years while resetting the way we live, we have a chance. It's the kind of leadership that we're talking about where it's not all about me. It's not all about leaving people behind and proving you're richer and better than everybody else. Comfortable and safe living is not a sin, actually it is the goal of a democracy. But it has to be more about us.The On Leadership blog was launched to address the importance of connection, collaboration, and embodying a service leadership mindset in professional and personal contexts. YCSC Assistant Professor Daryn H. David, PhD directs the column and serves as associate director for leadership development in the Yale School of Medicine (YSM) Offices of Academic and Professional Development and Diversity, Equity, & Inclusion.