I'm on my anesthesiology rotation right now and working with an an African American CRNA. Usually the people I'm surrounded with in the provider role are white and Asian while the scrub techs and other staff are black and brown. "Back on the plantation" as a Black medical school classmate of mine would bitterly assert when talking about the clear racial underpinnings of power dynamics in the hospital. I was waiting in the OR and when he first walked in I initially thought he was a scrub tech and nevertheless politely greeted him. As he walked over to the anesthesiology counter I immediately stood up and introduced myself as respectfully as I could to counter the automatic assumptions I knew I was still making in my head. Last week when an Asian scrub tech walked in, I assumed he was the attending! Granted, I knew my attending had an East Asian last name but, again, at fault. The CRNA and I began chatting as we walked to see the patient. As a tall, white man swooped in without as much of a hello to either of us, the CRNA looked at me and grinned, "that's the attending. I've worked with him before and don't think he likes brown folks like us very much". I nodded. He continued "I mean he's never said anything to me and it could just be that he doesn't like me personally". Without thinking, I muttered, "well sometimes you just know at a visceral level. The unspoken still leaves an impact". He looked back and smiled and we looked at each other in silence as the attending walked out and away without a word.
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The white doctors thought she was faking it. “She’s just pretending that she can’t walk,” my resident said dismissively. We were caring for a little black girl with sickle cell anemia, and I had rushed to report that the usually peppy child couldn’t walk, observing the girl’s large eyes water as she struggled on the hospital floor. My team of doctors, all White, commented on how “dramatic” the child was being, and that her worsening hip pain was simply a ploy to stay in the hospital longer.
Stay longer? I thought. What child wants to stay in the hospital longer? Several hours later, we are called frantically to the little girl’s room. I see the purple beads in her hair shake and jump as the child suffers a seizure and loses her eyesight to PRES syndrome, a rare complication of worsening sickle cell anemia. The little Black girl had to experience a near-stroke and temporary blindness before her doctors understood that her pain was not a lie, but a symptom of something very serious. The idea that a Black girl was "tricking" them to stay in the hospital longer was abominable. I've looked back on this story many times and was never able to separate the racial bias from the outcome we observed. Afterwards, the resident who dismissed my concerns never brought up the girl to me, or expressed remorse for missing the signs. Nobody ever debriefed about what happened, but continued seeing patients as if the girl's complications couldn't possibly have been caught earlier - even though I had brought it up to them. I will never forget the girl's mother repeating "it will be okay, baby" over and over again, tears streaming from her eyes, as the little girl shook in pain. For many Americans, the news of Donald Trump's victory in the presidential election is met with fear and despair. Many citizens are worried about their safety, access to health care, and wellbeing in this time of uncertainty. Ultimately, many Americans are wondering whether this nation's values reflect their own.
At Systemic Disease, we continue to believe that American values include diversity, equity, and justice. We will never stop raising awareness about discrimination in healthcare and raising a mirror to the issues that plague America today. We stand in solidarity with all members of our community and for our partners in the cause. We fight on to protect the sacred ideals that our flag represents, and thank the brave leaders before us who pushed for justice and battled for our nation to bring us to this moment of reckoning. On Veteran's Day, let us all resolve to act on our principles as veterans have, and contribute to our democracy. Join the movement and fight to eliminate bias at Systemic Disease. Raising awareness about prejudice in medicine is crucial now more than ever. http://www.systemicdisease.com/volunteer.html I went to the school administrator to discuss the topic of diversity and admissions, with the hopes that I was about to engage in a productive and thoughtful conversation.
After talking with the administration about diversifying the student body and broadening admissions outreach, they told me that students of color would be more likely to come to the university if I were the face they were talking to. They also stated that students of color tend to turn down admissions to this school (a top-tier institution) even though the school admits plenty of people of color every year. They also asked me to take on what seemed like an unreasonable amount of work to recruit students of color to this university myself as a medical student. I thought, shouldn't this be someone’s full time job? I left the meeting feeling discouraged and guilty that I didn't want to take on the work. Can't I just be a student looking to further my education, or must I be the face of a university that doesn't support me? I still struggle with this conversation and wonder if I should have said more. At lunch today, I sat alone in the residents' lounge working on a note for a patient. An attending for another service came in, sat down, and started making conversation with me.
The conversation started off benign -- how many languages do I speak, what did I study in undergrad, what was my research about -- but when I mentioned my research abroad, he began telling stories of when he went backpacking in his twenties. "Where I'm from, you have to be tall and handsome and probably blonde for chicks to want to sleep with you," he told me. "But there, you'd just talk to them and they'd fall into bed with you." I found it harder to keep eye contact, disgustingly aware that I am a woman in her twenties, not unlike the ones in his story. "I think I have some PTSD from seeing my friend, you know... because we shared a room together. And then we made a rule that we wouldn't do it anymore for the rest of the trip," he said. "But then we got to Rome, and we broke the rule. And then we got to Prague, and we broke the rule again..." I started texting my partner from my open laptop, telling him what was happening. The door to the residents' lounge was locked, no one else knew we were there. The attending seemed harmless, but here he was talking behind closed doors about the sex he'd had with women my age, having spoken to me just once before. I was nervous. "But that was twenty years and forty pounds ago. Of course, I'm married now. And I have two daughters -- do you want to see?" I didn't want to move closer to him. But I was afraid of what he would think. He was scheduled to be my attending and evaluator the next week. I survived assault before and I've learned to protect myself; but for a moment, I considered my grades before my safety. His phone rang, and after a minute, three of my classmates walked into the room. I texted my partner, "I've been rescued." |
