On my outpatient family medicine rotation, I met a patient I will never forget. She was a white middle-aged woman — a new patient to the clinic — there to establish care. When I walked in and introduced myself, she looked me up and down with a glazed expression.
Within two minutes, while I was trying to gather a history from her, the patient interrupted to say, “Dr. Smith (name changed), isn’t he the best? It’s so refreshing to finally find an all-American doctor.” I knew from that statement that this conversation was about to take a turn for the worst.
“All the immigrant doctors are taking over,” she said, “And all the specialists I’ve had to see have been brown men with thick accents, and I’m so relieved to have found Dr. Smith!” She was sitting comfortably in her chair, her legs crossed, looking me straight in the eyes, while I was standing awkwardly by the sink, fidgeting, trying to avoid eye contact with this woman.
I wish I could tell you I said something smart, enlightening or witty back to this patient, but I did not. I am an immigrant from the Middle East and a student doctor. But to her, I was yet another brown immigrant doctor — a nuisance to patients like her who prefer their doctors with whiter skin. I was speechless and confused. How could she feel so comfortable saying these views to me? I bit my tongue, gathered her history and examined her. “No offense honey,” she added, “But we’re still in America last time I checked and is it too much to ask for an American doctor for once?”
Dr. Suzanne Barakat describes her own struggles with patients who harbor racist views against her in her TED talk. When these microaggressions happened in front of a big group of people, the discomfort of confronting the aggressors kept others from standing up for her, a deeply hurtful, disappointing and for me, a familiar, experience. Before we went back into the room, I briefly told Dr. Smith, my attending about the patient’s comments, fearing he would think I was over-dramatic. He raised one eyebrow, shook his head in disapproval, but did not utter a single word. I walked back in the room right behind him, and the patient grinned, and eagerly shook my attending’s hand. I was in the back, feeling invisible and a little numb. I didn’t expect Dr. Smith to scold the patient or to give her a lecture on basic human decency. Truthfully, I’m not sure what I expected, but I remember feeling so small and so insignificant, in disbelief that this patient encounter was treated as routine by my attending.
When I had time to digest what had happened, I thought about what would have been an appropriate reaction to this incident, which, unfortunately, might happen to me again in the future. As physicians-to-be, we still adhere to the Hippocratic oath. We must care for all patients without discrimination. But what do we say to patients who blatantly disrespect us, share their racist views about us and those who look like us? Do we stay silent like I did, because they’re our patients after all, and a clinic is not the place for such discussions? Or do we stand up for ourselves and our colleagues who face similar prejudice and risk the fact that the patient may never come back to see us again?
So maybe when a patient says something that qualifies as a microaggression to me or a colleague in the future, silence cannot be an option. Maybe we can muster up the courage to say something when one of our colleagues is in such situation. Maybe we can care for our patients and treat them with most utmost respect and dignity, but still maintain our dignity. And maybe, just maybe, we can change a couple of minds in the process.
Nada Awad is a medical student.
Image credit: Shutterstock.com