Articulate is not a compliment: Ending the pervasive culture of racial microaggressions in healthcare.

I remember being ushered into an empty office and sitting down in a red chair placed directly in front of a cherry wood desk. Picture frames of a white family – mother, father, daughter, son- graced the desk in the office. I glanced repeatedly at the walls were decorated with multiple framed diplomas as I sat nervously in the chair. Abruptly, the door swings open and a slender white woman with a brown bob dressed in a grey suit rushes into the room and seats herself behind the cherry-wood desk. She apologizes for her tardiness and introduces herself as the dean of student affairs at the medical school. “I’ve read all about you.” she says “Now tell me again, why do you want to be a doctor?” I proceed to go through my story, the one I had rehearsed countless times. The story about my origins of being the daughter to a Nigerian immigrant visiting nurse who would take me with her on home visits, my close relationship with my pediatrician, my summers in Nigeria seeing family members who lived in extreme poverty and how it had all culminated in an innate desire to help people.

It was a powerful story.

I stopped, ready to field any and all clarifying questions related to the monologue I had just delivered. The dean cleared her throat, looked at me and said one sentence. “Wow, you are so well-spoken.” And then she waited. I believe she was waiting for a response of gratitude to what she believed was a compliment. So I smiled and muttered a “Thank you so much.”. After that, she proceeded to rattle off facts about the prestige of the medical school, including their robust commitment to having a diverse student body. Yet, I don’t remember the rest of the interview day, but I remember that scene vividly. I couldn’t then and still can’t shake the thoughts that entered my mind- was she listening to my story or was she amazed at the fact that I could put multi-syllabic words together coherently, despite completing high school and college?

That was my first microaggression, which happened over 15 years ago, but certainly not my last. I think many of us as women physicians have had the “pleasure” of being mistaken for a nurse. Yet as a Black woman physician, I remember walking into a room to see the next patient during my emergency medicine rotation. Despite having my white coat and stethoscope on, before I could utter a word, I was quickly told by the mother of the patient in the bed that the lunch tray was in the corner and thanked for coming in to pick it up. Just fyi: I walked out and never returned.

I recall being greeted during medical school numerous times with a “Yo, how ya doing?” by fellow white students, because that’s how “we” speak, right? More recently, as an attending physician, I was asked at the end of a clinic visit- “It was nice meeting you but when is the real doctor coming in?”. I wish I could say during each of those incidents I responded with a witty and stinging remark that made them feel the pain that I felt from each incident. Unfortunately, I wasn’t built like that back then. Actually, I hardly even acknowledged them as offenses back then but I did know that they induced a negative feeling about myself, close to self-doubt about my belonging in this profession.

It wasn’t until residency when I realized that the constant barrage of these tiny mosquito bites, had created a full-blown allergic reaction of constantly feeling that I didn’t belong. It led to me trying to figure out what repellent I could wear everyday to stop the bites. I tried different ones- becoming invisible and not talking or drawing attention to myself during rounds would help. I tried pulling back my growing natural locks into a bun, that would help people see my white coat and stethoscope and finally realize I was a physician, right?