It’s time we stop saying “black cloud” and “black weekend”

Racism is a pandemic that has long existed before COVID-19.

As a fourth-year medical student, I have been rotating in the hospitals and recently finished my sub-internship. Whether on the wards or in outpatient clinics, a recurring phrase would hover from one provider to the next, depending on how busy their week was: “black cloud” and “white cloud.”

In the medical world, the former has often been used to describe trainees or attendings with a high number of admissions or complex cases, while the latter has been associated with a lighter load and fewer pages. Phrases like “black weekend” versus “golden weekend” have also been tossed in conversation. When I rotated on my 3rd-year medicine clerkship, “black weekend” described a weekend where residents worked both Saturday and Sunday, while a “golden weekend” saw both days off.

With the broader state of our nation today, we need to step back and critically reevaluate this terminology.

How did these colors come to represent such perceptions? People may have unconscious bias. They may not realize they are attributing negative connotations to these phrases. It is almost as if the medical system is associating “whiteness” as good, something to aspire to, and “blackness” as negative, something to avoid. Black physicians have voiced their concerns, encouraging other providers to “dissociate blackness from negative thinking.”

Communication is a cornerstone of medicine. Language and thought are closely interconnected, reflecting each other. Just as words open a door to our thinking, so, too, do our thoughts influence what we speak. And how we speak with our colleagues, how we speak about our patients, and how we speak about ourselves – all of that matters.

The system will not change overnight. It, unfortunately, has persisted for hundreds of years. People’s voices are being lifted up as they shed light on their experiences, and yet, there is still a long way to go.

I am certainly no expert on how to enact change. At one point, looking back on my 3rd-year medicine clerkship experience, I confess I had even used the phrase “black weekend” to describe a full weekend without a day off. It had seemed to be the accepted jargon on the wards. But now I am all the more conscious about my language. I want to wield my words for good.

There are changes that people in the medical field are proposing. At recent grand rounds at my institution, the guest speaker gave a talk on protecting children and families from racism, bias, discrimination, and hatred. Towards the end, he put forth some suggestions, both institutional and individual. One was a simple option to shift the language we employ. For example, instead of “black weekend,” why not simply say, “double,” “on-call,” or “covering” weekend? Instead of “white cloud,” what if we altogether stepped away from assigning the amount of clinical busyness that we attract? (Many hold firm to their perception, whether self-imposed or peer-influenced; however, studies have shown to debunk the superstition.)

Habits may be hard to break, but we can do this: we can change our language. If we care about our black colleagues, trainees, medical students, and attendings, we should care enough to shift the way we communicate. From medical students to residents, from fellows to attendings, we hold the power to use our words for good.

Racism has been a systemic issue in medicine, a weed that has yet to be fully eradicated. It will not die overnight. But together, one by one and collectively, we can pull at the weed, even with something as simple as changing our words for the better.

Anna Delamerced is a medical student.

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