It was as if my four-day-old daughter’s condition was not critical. It was as if I was not a clinician who could confidently assess and identify seizure episodes. It was as if there were no monitors blatantly showing critically low oxygen levels.
Nine long hours and still no response. I felt like I was begging for eternity. I had repeatedly approached the nurses’ station to get their attention and assess my daughter, but all they did was record the desaturations as they happened. In medicine, we usually intubate when oxygen levels are in the 80s. However, my precious baby’s oxygen levels fell to an alarming 51 percent so many times, and yet — still no course of action.
It was not until I called a friend, another female, Black pediatrician, who was not on call. I explained my current situation, and she immediately called up the attending physician regarding my daughter’s status.
If I were white, would the situation change? Would I need to call a friend just to be granted the right to proper medical care?
You see, things like this aren’t new. Racism has become deeply ingrained not just in history but even in day-to-day living. Racism has established its roots in so-called white supremacy — even in the realm of medicine — and this has become so authentic to me. So real that discriminative acts like this did not only happen to me once. So real that I could still vividly remember my first pregnancy when I needed to undergo an emergency C-section after a failed trial of labor. It was the most horrible experience for a first-time mother.
I was given a poor choice for anesthesia. Despite screaming in pain and begging multiple times for more pain medications, they, white female obstetricians, went along with their business of digging and cutting in my belly despite breakthrough pain. And after what seemed like an eternity, the white male anesthesiologist finally gave me the pain medications I needed to dull the pain.
And it did not stop there. I had a massive postpartum bleed right after the delivery. When I bled the second time, I immediately told the nurse on duty. To my frustration, she didn’t check on me, told me, “I was fine, I just checked you,” and simply walked out of the room while I lay helpless in a pool of postpartum blood. My nurse was white.
I could not believe I experienced firsthand the impact of systemic racism. A specific kind of bigotry catches us off-guard at one of a female’s most vulnerable moments – during childbirth. Black women are three times more likely to die after birth than white women in the United States. It is a fact too difficult to ignore. Everyone is too aware of it such that we do our best to avoid certain hospitals and providers in an attempt to prevent adverse outcomes.
I can count numerous other stories where the voices of Black women were largely ignored. The New York Times article from December 25th, 2020, describes, “Dr. Susan Moore died of COVID-19 after complaining of racism at Indiana hospital”. Or perhaps the story of Dr. Chaniece Wallace, a fourth-year pediatric chief resident who died after pregnancy complications. Or maybe the story of Sha-Asia Washington, in NYC, who died during an emergency C section. Sha-Asia, too, had voiced her concerns multiple times, and she was ignored over and over again. Kiara Dixon Johnson, age 39, died April 13th, 2016, after begging for her life for more than 10 hours. She was bleeding internally from a massive bleed after a routine c-section. Countless other Black women have had similar stories, but I only shared a few. Racism and discrimination come in many facets, but the systemic consequences remain the same – it is contagious, and it takes lives.
According to the CDC, most pregnancy-related deaths in the U.S., 60 percent or more, could have been prevented. Also, the challenges for Black women increase by age and are not affected by education, location, or status. Even celebrities like Serena Williams and Beyonce have voiced their concerns about their deliveries and poor treatment. If these celebrities are affected, then no woman is exempt.
But what makes this prejudice more difficult to swallow is that it does not recognize educational and professional backgrounds, intellectual capacities and even your contribution to society. Your color decides whether you get the proper treatment, the right provider or whether you have the right to live. And even Black female doctors — Black females who chose to go after a very noble and self-sacrificial profession – are not exempt from it.
It is what makes being a Black female doctor more agonizing.
We would be naive to think an “MD” after our name would protect us from the reality of being Black. It simply accents our “Blackness.” The pressure of being a professional in a very biased world can be utterly suffocating.
We have come to terms with “Blackness” all our lives. We have to teach our children, from an early age, that they are Black and that they must hold themselves to a higher standard than their non-Black peers.
And the stories do not end there. For instance, the feeling of being “passed over” is all too common. I have personally experienced flying in the United States, where a flight attendant made it evident that she had no intention to serve me — but made the deliberate effort to acknowledge other guests around me repeatedly.
Nonetheless, I have become all too familiar with the probing stares and the rude questions. To add more salt to the wound, your non-Black peers will attempt to gaslight you and tell you that your reality isn’t real. When you take the high road and work harder, you are a bigger target. This is a sentiment I have shared with other Black women, and I am very confident that I am not alone with these thoughts.
Black women in America are some of the most stressed and abused groups. Even though Black female doctors represent only 2 percent of all U.S.-based physicians, we experience a disproportionate amount of discrimination. We receive treatment from our peers, which any other group would not tolerate. Microaggressions such as derogatory references or mockery are common to them compared to white male doctors who receive apologies for wrongdoing.
Whether or not an attempt to eliminate these biases is made, we can never be sure. The existence of this type of prejudice in today’s modern society explicitly shows that first, these biases were allowed to exist, and second, attempts to eliminate them must not be that strong as to create a profound and lasting impact from generation to generation.
Way back in 2020, I was in an abyss after a decade of practice. After years of feeling the blatant double standards being myself and my white colleagues, frustrations spilled over. Having a constant microscope on me and having unreasonable expectations forced on me worn out every fiber in my body.
My experiences were nothing new, as countless Black women and men had experienced this. However, in 2020, the brutal murder of George Floyd must have caused the world to take notice and for tens of thousands, globally, to say that we have had enough.
Last year, the world as a whole received a considerable jolt. Many people of color were not immune. Black doctors watched in horror as they saw their fellow Black men being murdered by police officers. They felt frustrated when visiting injured protestors at the emergency room who looked like them. Still, they had to remain neutral while treating injuries that could have been inflicted on them. For many people of color, that “rude awakening” exposed the pain and frustration they had attempted to bury as deep as possible- the painful truth that discrimination was alive and well in America.
The words of George Floyd haunt me as a woman, as a mother, and as a person of color. After the initial shock and numbness from the global display of grief and anger, I wept for him as I could relate to him on many levels. His experience of begging for his life, crying out, and saying “I can’t breathe” triggered a myriad of memories.
George’s crying for his late mother struck a chord deep inside my soul. It brought my mind to a memory that I had so desperately wanted to forget — begging in a hospital, where I once worked, to get the nurses’ attention that was supposed to be looking after my four-day-old child. At that moment, I was not just a Black mother, but I was also a Black doctor who knew when her child needed help and immediate medical attention.
As a Black woman in the medical field, I carry extra weight on my shoulders. I must prove to others that I am good enough for this profession. I must let them see that I am competent and that I have something to give and offer. This is a fact that most people do not understand because they have never had to deal with our struggles firsthand.
If, as a Black person, I had to prove myself worthy of being given attention, now, as a Black physician, I had to prove myself worthy of being recognized as a professional who could offer something of value to humanity.
The agonizing trauma of racism must be endured along with the excruciating truth: our medical degrees as Black physicians are not enough to shield us from the metaphorical knee on our necks.
Being a woman is also difficult in society, but we are often all too aware of the apparent display of unfair racial disparities as Black female doctors. Women face sexism and discrimination while still earning less than their male counterparts who do the same work- and change must be initiated. In a profession where voicing your concerns could mean immediate dismissal and forfeiting advancement in one’s career, being Black further amplifies the difficulty of having a voice in society.
As physicians, we are reminded to stay in our lane and be constantly aware not to seem bossy or pushy when speaking is necessary. It has been instilled in us that the strong woman stereotype means “suck it up” instead of standing with authority on what you believe needs addressing.
This pervasive ideology continues here — with the idea being pushed onto us by men who hold positions above ours. It is hurtful because, if these ideologies had been appropriately addressed, they would never have become an issue at all. As a clinician for over ten years, I can assure you that the struggle against the ideology continues to persist, and we need autonomy from this narrative imposed upon us by those who think they know better than we know ourselves.
You’ve heard of the glass ceiling, but what about that invisible weight on your back? As Black women doctors, we have to carry a burden sometimes just for being who we are. When we walk into any room and meet a new patient for the first time, they often expect more from us — not because our qualifications aren’t as good or different from others but because society has told them so many negative things about African Americans womanhood.
Then you speak of a pandemic, where people are making issues with regards to wearing a mask, citing an issue of violation of human rights. Internally, I wince because I feel so many people use the term recklessness in denial of their unique privilege that many Black physicians do not have.
This is the hard truth. Black female doctors are standing at a precipice, and it’s undeniable.
We are in the most undesirable position: many of society’s negative preconceptions are being thrown our way with little to no control over this situation that we find ourselves in.
The pandemic has heightened our and society’s awareness of our concerns. Black is synonymous with lower status in society. Females are considered a lesser of the sexes. Doctors are placed in an unpleasant situation to be superhuman and work at the highest level, under constant pressure, with little regard for our self-care.
Writing these words is not easy, as it forces me to come to terms with a deep betrayal and the flood of emotions that go with it. Serving a system that we have made countless sacrifices for, yet does not live up to its responsibility, feels like a betrayal. Imagine working in a scenario where you know you would go the extra mile to be attentive and caring towards your patients and team members, but deep inside, you know you might not be given a fraction of the care you provided.
And the irony is: this betrayal is not at all surprising.
I have been a practicing physician for over ten years, but I grew tired after countless hours of service and dedication to the profession. I left clinical practice to pursue other ventures because I needed to remain authentic to my truth. The agony, betrayal, and gaslighting were too much for me, so I left clinical practice. Working in a system that threatens your sense of safety, over and over again, is mentally and physically exhausting.
The system betrayed me repeatedly until I was fed up with everything it claimed to stand for. At first, this anger manifested in feelings of betrayal, which then yielded to mental and physical exhaustion. I felt alone, as it wasn’t as if I received much, if any, support and acknowledgment from my so-called “colleagues.”
Then I realized that not only are Black female physicians affected by these problems, but we are also more acutely aware because we often lack support networks or mentors from within our own demographic. This explains why many of us feel our voices will never be heard.
Regardless, I say this: I am a woman of history who stands up and tells the truth, irrespective of what other people say. I remember the words of the late Representative John Lewis, “Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of a day, a week, a month, or a year. It is the struggle of a lifetime. Never, ever be afraid to make some noise and get in good trouble, necessary trouble.”
Black female physicians are not OK, but it is our collective duty to do something about it. It is our collective duty to go against the tide. It is time to take a stand and institute change that we need to initiate ourselves.
Tomi Mitchell is a family physician.
Image credit: Shutterstock.com