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Medicine vs. racism: white coats for black lives

Divya Seth, MD, MPH
Policy
June 3, 2020
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Six years ago, Michael Brown was murdered in Ferguson, MO, igniting the White Coats For Black Lives movement. I was a medical student at the time. As we prepared for a die-in in protest of Michael Brown’s death and the officer’s acquittal, my medical school class erupted into debate. Some felt strongly that we should not wear our white coats during our protest.

The white coat holds immense symbolism for the medical community. It joins us to a community of dedicated medical professionals. It is our profession’s uniform. For many in my medical school class, regardless of their personal beliefs, protesting was not the issue. When we donned our white coats, however, we were breaking what many considered a sacred separation between our profession and our “political” beliefs.

Many believe that doctors and medical students should not protest nor hold controversial positions while wearing their white coat — because in doing so, they falsely represent an opinion that all of medicine may not have. In this vein, when someone in a white coat speaks, he or she is speaking for all the white coats. Should we, as a profession, aspire towards crafting a public identity that is ideologically sterile?

I agree that a uniform — whether it be the short coat of medical student or a doctor’s long coat — holds a certain power, a certain responsibility, a certain identity. But that uniform should not be the reason why one steps away from a conversation. It should be why someone joins it. A uniform creates a community and it creates an identity, but it does not silence the voice of the individual who dons the uniform.

Now, George Floyd, Ahmaud Arbery, Breonna Taylor, and too many black Americans before them, are all dead. There is no question – racism is a public health issue. It is a medical issue. As a resident physician, I have spent the last four months trying to help my patients breathe in the face of COVID-19. My patients have been mostly black and brown, and they too have told me, “I can’t breathe.” Everything we have done in the hospital over the past four months has been done to help our patients to breathe easier. Our work needs to extend to outside the hospital. It means fighting the injustice that prevents our patients from breathing, battling the structural racism that makes it more likely that black patients will suffer from COVID-19, and raising our voice against the racism that puts a knee on the neck of a black man.

Much of the culture of medicine is about remaining impartial or civil or professional. But racism impacts my patients, it impacts my colleagues, and so, it impacts me. Our field is dedicated to the betterment of humanity. It is about placing the patient first. Our black patients are dying because of racism at all levels. We must raise our voices with them and for them. Our profession does not separate us from the events of the world. It does not separate us from the very human forces that shape the people most important to us: patients. The white coat is not a pedestal; it is not a reason to remove oneself from the very timbre of society, from the discussions that take place.

Racism is causing the largest public health crisis of our generation. We, as health care providers, need to actively take part in this fight. We will speak up, we will stand up, and we will practice anti-racism at home and at work. We will discuss recent events with our teams and our colleagues. We will consciously consider our medical education, our departments, and our institutions. Our patients will inevitably be shaped by current events, and we, as humans, will be too, and it is unreasonable and unjustified to use the white coat as an excuse for not being engaged, or remaining uninvolved. Furthermore, medicine does not operate in a vacuum, it shapes, and it is shaped by justice, economics, and politics. To deny such is to deny reality.

Divya Seth is an internal medicine resident and can be reached on Twitter @dseth1106.

Image credit: Shutterstock.com

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