NORFOLK, Va. — The inoffensive images show photographs of aspiring doctors in white lab coats tending to patients, or lounging on the beach in swimsuits, or posing with family members in their Sunday best. But as one flips through the yearbooks at Eastern Virginia Medical School, shocking images pop up, too. Ku Klux Klan attire on one page. Confederate outfits on another.

When reports emerged that Gov. Ralph Northam of Virginia had a racist photograph on his page in the 1984 yearbook, it not only sent his political career into a tailspin, it also cast a negative light on a tradition at the elite school that turned ugly.

For years, each graduating student was given half a page in the yearbook to leave behind memories. Some inserted poetry. Others left reminiscences. There were photos submitted by the graduates, some heartwarming and others jarring in their insensitivity.

In 1984 alone, besides the picture on Northam’s page of a man in blackface posing next to someone in a KKK robe, there were at least two other images of blackface in other parts of the yearbook. There was also a picture of a man wearing a sombrero and a woman in Japanese attire at what seemed to be a costume party.

One photo featured a professor holding a mug that read: “We can’t get fired! Slaves have to be sold.”

And a male student grabbed a female mannequin’s breast in one picture with the caption, “I try never to divulge my true feelings while examining my patients!”

The tradition carried on with little fanfare until 2014, when Dr. Richard V. Homan, two years after becoming the medical school’s president, learned that there were photos of students wearing Confederate outfits and flags in the 2013 yearbook. Concerned that the images could offend and portray the school in a negative light, he ended the publication of yearbooks.

At a news conference Tuesday, Homan apologized for the offensive images of the past and described an investigation he ordered into the campus culture that may have led to their publication.

“We want this to be more than just a review of what happened 30 years ago,” said Homan, who is white, and also the provost and dean of the medical school. “We want to know what’s happening today and what we can do to make things better.”

Black students from Northam’s era recalled a divided campus in which they and their white classmates sat in class together but largely socialized apart.

“The problem is that people who put offensive things on their yearbook page, they weren’t cognizant of the people they were offending,” said Dr. David Randolph Sr., 59, an oncologist in Richmond, Virginia, who is black and who graduated from the medical school in 1983. “They had no concern for the people whose feelings that they were hurting.”

Some white students said that nothing seemed out of the ordinary when their white classmates wore blackface. It was typical at costume parties or at talent shows, said Dr. William Elwood, a retired family physician who is white and who graduated in 1984, the same year as Northam.

Elwood worked on the yearbook that year, laying out pages, he said. For their personal pages, students would submit their own photos to the staff, he said. The designers would lay them out on the page, he said, and mark where each photo was to be placed. The photos were then put into an envelope, which was attached to the page where they belonged and sent to the press to be printed.

Northam, after initially saying that he was in the offensive photograph on his page, has since said he was not and that he had not seen the photo before.

Elwood said he did not recall laying out Northam’s page. But he did recall the yearbook including a picture of three men dressed in wigs, dresses and blackface, pretending to be The Supremes, he said. It did not offend him, and he did not think twice about whether the photo should have been in the yearbook, he said.

“It was done as part of a dress up, being somebody you’re not,” Elwood, 68, said. “It was not done as some kind of racial thing.”

The use of blackface, he said, came down to context and the prevailing attitudes of the time.

“I hate that people take something that happened 35 years ago and put 2019 values on,” he said. “Values and politics and perceptions have changed since then.”

Dr. Aaron J. Pile, 66, a black obstetrician-gynecologist practicing in the St. Louis area, said he considered blackface offensive even 30 years ago. He said he did not receive any offensive photos when he was a yearbook editor in 1983, and if he had, he would not have permitted their publication.

The students were given free editorial rein over the yearbook, without staff supervision, because “the yearbook was for us,” Pile said. “It wasn’t for the teachers; it wasn’t for the faculty.”

That freedom, however, may have also resulted in some of the offensive content that ended up in the yearbooks, said Dr. Harvey Rawls, 60, a white classmate of Northam’s.

“The practice of letting students run a yearbook unsupervised should have just been shut down,” he said.

Even as their beliefs on racism may have differed from their white classmates, Pile and Randolph said the school’s administrators created a welcoming environment. And they appreciated the school’s mission to encourage doctors to work in primary care, helping underserved communities.

The only time Randolph felt directly targeted because of his race in medical school, he said, was when he was doing a hospital rotation. The chairman of the department, who was white, called him into his office after about six weeks and told him that he thought he was going to fail, Randolph said. He found that strange, he said, because he thought he was performing well and the chairman had never met him.

While the chairman told him he could go ahead and quit, Randolph asked if he could instead work directly under the supervision of the chairman to show that he did good work. He did, and by the end of the rotation, Randolph said, the chairman had written him a glowing recommendation.

“He made a decision that I was a poor student; I was going to fail based on my race,” Randolph said. “I showed him.”

Randolph enjoyed academic success, but white students generally had different cultural and social interests and would have gatherings that black students often knew nothing of, he said. It felt as though black students were invisible to their white classmates, he said.There also was an economic divide: Many of the black students were the first in their families to go to college, let alone medical school, and they did not have the same resources as their white counterparts, he said.

The gap between black and white, Randolph said, was why he felt that white classmates probably would not have blinked at the offensive image on Northam’s yearbook page.

“That was the norm,” he said. “That’s what people did.”

This article originally appeared in The New York Times.