Medicine in the shadow of the Confederacy


To get to my primary care clinic in Richmond, VA, my patients and I must walk past the Confederacy’s White House. Our emergency room sits in its shadow. Each day, I walk past the three-story white building surrounded by my hospital on three sides. Renamed the American Civil War Museum, it is now repurposed to sterilize hospital staff masks. The faded letters of a long-removed sign on the front read “The Museum of the Confederacy.” The majority of my patients are Black Richmonders, and as their white physician, I owe it to them to examine and fight bias, which oozes from the health care system and even from myself. As a physician and a citizen, I am not their savior, and I do not speak for them. I strive to be their ally.

My institution has a well-documented history of mistreatment, discrimination, and violence against Black patients and community members. Each day of medical school, I walked over a now-covered well, where once rested the bones of Black Richmonders, stolen from their graves and possibly killed to serve as cadavers for medical students in the 1800’s. I walk past a Confederate church and a library named for a Confederate nurse. Efforts have been made to recognize and rectify these atrocities, and my colleagues now include national experts in health disparities and thousands of caring nurses and physicians. But as I speak with my Black patients’ about their experiences, I am urged to do more.

I speak with my patients about discrimination and violence frequently because it directly affects their health. Social justice is the job of every physician. Because I make space for this conversation in my exam room, I have had the privilege of hearing detailed stories from my patients about this discrimination. The patient who told me he needs to exaggerate his pain to be believed after being ignored by so many. My Black patient whose white wife was offered immediate treatment for the same condition he was placed on a six-month waitlist to receive. The patient who after the killing of Freddie Gray directly asked me if I was denying him pain medication because he was Black.

When confronted with our own bias, it is easier to closely examine our thoughts and actions. What is harder, for both individuals and systems, is turning the mirror on ourselves when no one is watching. This requires constant practice and attention. Walking past the Confederacy’s White House each morning allows me a moment of meditation. I honor my patients’ experiences, I think of how I may have contributed to discrimination, and I plan to work to correct it.

I thought of writing about this for years, but have hesitated. I felt it was my duty to listen, not to add to the chorus of white voices overpowering Black voices for hundreds of years. I feel now that it is my duty to be a vocal ally. Never to fully understand, but to seek the deepest understanding I can reach and challenge all of my colleagues in medicine to do the same. Colleagues, be not afraid of discovering your own bias. Do not become defensive when challenged about this. It is our duty to our patients and Black colleagues to rise to this challenge, because we are the ones who must change. Our Black patients, mothers, and infants suffer from our discrimination and inaction. As we call for change in our nations’ police and criminal justice systems, it is time for us in medicine to put the fire out in our own house.

Megan S. Lemay is an internal medicine physician. 

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