Doctoring differently: What I have learned after 5 years as a Black woman physician with a disability.
"Disability is pain, struggle, brilliance, abundance, and joy. Being visible and claiming a disabled identity brings risks as much as it brings pride.” - Alice Wong
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I had no idea that my body could speak to me. I had no idea that it was fighting for me to listen until it stopped fighting.
It has been five years since the day my life changed completely. Five years ago, I had to confront the fact that my body required respect, boundaries and support. In May 2019, my body gave me an ultimatum- it would no longer submit to my neglect, and we would have to exist together. I refused and ended up in a hospital bed.
For so many years, I pushed my body to fulfill everything I wanted and more often, everything that others wanted. I was both ambitious and a people-pleaser, which is a toxic combination, especially for a physician. If I had a plan, I was definitely going to execute it. If someone needed it, I was going to deliver.
When I decided my career path would include medical school. I immediately started to recall the images of physicians that I had been exposed to in real life (few) and on television (many). For me, the common pattern was that doctors were perfect and strong. They could withstand challenges that might be difficult for regular humans to overcome but not them. Instead, they were superheroes who didn't need sleep, food, or even connection. Sure, it was lonely work, but this was their calling- to learn and to work hard, no matter what. As a Black woman, the only modification was that I was to work twice as hard.
When I finally entered medical school, I found out that I wasn’t far from the truth. While the goal of our work was to restore wellness, our training required that we deprioritize wellness. My fellow students and I would regularly engage in sleepless nights, consume meals irregularly, and choose sedentary studying over body movement.
When I entered residency, the training went deeper. Now, our mindset had to change. I fully believed that I no longer needed sleep, good nutrition, or exercise. Work always came first. The patients always came first. The hospital always came first. By the time I finished residency, the indoctrination was complete. I had conditioned myself to ignore my body's needs.
So after years of being ignored and mistreated, my body went silent and became complacent with this new normal. So it's no surprise that my body literally had to go to drastic measures to get my attention again.
Initially, it started with unsteady walking, then progressed to severe nausea and dizziness, and finally culminated in a complete inability to walk.
This was my body’s attempt to stand up for itself, and funny enough, I didn't listen until it made me sit down.
It was a cruel joke to see myself, a global health pediatrician who was always on the move, unable to even go to the bathroom by myself, I found out that my symptoms were due to multiple sclerosis after a few weeks in the hospital. This is a disease where my body attacks the covering of my nervous system, myelin, and causes abnormal functioning. My MRI revealed a small lesion in my right cerebellum, the home of balance and coordination.
Once I found out that this was the primary source of my symptoms, I did what any anxious person would do- I ruminated on the things that I couldn't change. I asked myself, “Why did this happen to me?” and “What could I have done to prevent it?”
So, I spent my time researching and finally started to understand the relationship between autoimmune disorders and stress. In particular, I came across the research of ArlIne Geronimus, a researcher who coined the term “weathering” in 1990. Her work demonstrated that Black women were more likely to experience worsened health outcomes during pregnancy at earlier ages than their white counterparts due to racism-induced stress.
This was not your typical everyday stress. It was stress defined by a perfect storm of racism, chronic exposure to discrimination, microaggressions, and overwork in our professional and personal lives, complemented by structural racism that provides fewer resources & support.
Weathering accelerates aging and is shown biologically in the shortening of our telomeres (the ends of our chromosomes). Her research showed that the telomeres of Black women were seven years older than those of white women of the same age. Moreover, these shortened telomeres are also a risk factor for cancer, diabetes, and cardiovascular disease.
So armed with this information, I started to realize that I had overlooked a common pattern that I was seeing among the many Black women in my circle, especially among those working in healthcare. In addition to the everyday weathering that happens for Black women, those in healthcare have an additional stress that we have been trained to normalize and ignore.
Some of the women in my ecosystem were on as many as three blood pressure medications for hypertension despite adhering to lifestyle changes. I had friends who had been diagnosed with cancer in their early 40s. Some of my friends who ate healthy and had no family history were diagnosed with diabetes.
The stress that we were trained to tolerate was slowly and silently destroying us.