It's not just the police. We need to urgently address the fear that Black people have with the healthcare system.
"Neither love nor terror makes one blind; indifference makes one blind." - James Baldwin
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“You have been cast into a race in which the wind is always at your face and the hounds are always at your heels. And to varying degrees that is true of all life. The difference is that you do not have the privilege of living in ignorance of this essential fact.” - Ta-Nehisi Coates
“Just breathe.”, I silently thought to myself. I tried to ignore the squeezing pain in the center of my chest, as I gripped the steering wheel with both hands
I sat straight up, looking to the front, but I couldn't focus on anything in front of me. My eyes darted to the rearview mirror, waiting for the police officer to emerge.
I had seen the red and blue flashing lights but it took me a minute to realize it was my car that was being directed to pull over. I remember struggling to control a hand tremor that started as soon as I tried to retrieve items out of the glove compartment and my purse.
I tried to move as quickly as I could. I wanted to have everything ready so when the officer arrived at my door, I wouldn't do anything that would make him impatient, frustrated, or angry.
I was smart enough to know that my ignorance to why I was pulled over would not translate to innocence. As a Black woman in the US, I was also wise enough to know that a traffic stop was not too trivial of an encounter for me to strategize about how I would stay alive.
“Hands at 10 and two,” I whispered to myself. I reminded myself to smile and speak slowly. I quickly rattled off these and more instructions as a fast-paced monologue. I pleaded with myself not to make any mistakes. I had my license, registration, and insurance laid out neatly on the dashpad so there would be no sudden movements.
My grip continued to tighten as I repeatedly reminded myself to breathe. The unpredictability, the fear of an unknown outcome, was creating massive fear.
Every time I see a police car while I’m driving, I instinctively hold my breath. No matter how much I try to convince my brain that I am not in danger, It seems that my body doesn’t trust me. It will not allow my breath to escape my body again until the car has passed by.
It’s a subconscious fear, but in no way is it irrational.
I know it stems from the vicarious trauma of seeing people who look like me murdered so quickly and so easily. I also know it stems from negative personal experiences with the police.
One of my most prominent memories is a car accident, where I briefly lost consciousness on impact. I was in pain from my driver’s door being smashed into my thigh. I was trapped in my car. During that experience, I remember the officer, a White man, knocking on the window, pointing his finger downwards as an indication for me to roll down my window since I could not get out of the car. I remember his tone being a mix of annoyance and frustration, as he demanded I answer his list of questions, but it was the first one that was the most jarring.
“Okay, what did you do?”
I was not greeted. I was not asked if I was ok, despite the significant damage to my car. In my pain and disoriented state, I rationalized his lack of concern about my well-being, telling myself that sympathy may not come as naturally for some people.
After I gave him all of the information, he then walked over to the curb, where a White woman, who I assume had been in the other car, was sitting with her head buried in her hands. I watched closely as he sat down next to her, turned towards her, and patted her shoulder. The sympathy was evident, even without hearing the words.
I was stunned. At that moment, I quickly understood that I was guilty until proven innocent. Was it my hoodie, my Afro, or my Black skin? I would never know. I quickly saw that the woman on the curb was seen as someone who needed help, while I was viewed as someone who created problems.
I wasn’t shocked by this bias because I was very familiar with this feeling. I had witnessed it often, not with police but with healthcare providers.
I have seen patients experience the same kind of anxiety in the emergency room, waiting for the doctor and wondering how they will be perceived, treated and managed.
With this anxiety comes apprehension about sharing my story, about trusting if the person in front of me truly has my best interest in mind. In addition, this doesn't allow providers to receive the information they need to create the best treatment plans for their patients and can impact outcomes.
Creating a sense of safety in the US healthcare system for our Black patients shouldn't be a novel idea, it has always been critically necessary.
On one of my earliest rotations as a pediatrician in the ER in Boston, I remember walking into an exam room with a Black woman holding a young infant on her lap. She immediately asked me, “Are you the doctor?” When I told her that I was, she let out an audible exhale.
It was a clear sign of relief.
During our conversation, she revealed that when saw me, another Black woman, it alleviated two of her biggest fears at that moment:
that she wouldn’t be fully heard or believed and;
that her decision to seek medical attention would put her child’s life in danger, instead of preventing it.
And the truth is, these fears are more common than we think.
Every time we have a police encounter, Black people cannot rest assured that we will stay alive. Every time we have a clinical encounter, Black people cannot rest assured that we will stay alive.
It’s interesting how so many of my non-Black colleagues in medicine will vocalize their outrage about the racism Black people experience with law enforcement but will stay silent about the racism they see in the healthcare system.
Recently, the Kaiser Family Foundation shared results from their survey on racism and discrimination, revealing that Black adults, those with darker skin color, and adults with experiences of discrimination are less likely than their counterparts to trust healthcare providers. Past experiences with discrimination also are associated with lower trust in healthcare providers.
It is not surprising that there is shared terror of both of these systems. The racism that exists in both of these systems can quickly turn into life-and-death situations and stem from heavily imbalanced power dynamics.
Yet, when reports of medical racism are reported, they are not comprehensively addressed and dismissed. Instead, statements are released on how institutions will try to further work on diversity, equity and inclusion initiatives.
I am fearful when I have to bring my family or myself in for healthcare encounters. I am never sure if our concerns will be taken seriously and if full, comprehensive management will be undertaken. Sadly, I have seen a clear difference between the care I receive when I don’t mention I am a physician and the care I receive when I do.
There should be no difference.
However, let’s be clear that even the white coat doesn’t protect us. For Black women who are physicians, we have seen how their knowledge of the healthcare system did not prevent racial bias and their ultimate deaths, as in the cases of Dr. Susan Moore and Dr. Chaneice Wallace.
This is the reason that as a Black woman, the same anxiety I have at a traffic stop is the same anxiety I feel as a patient in the emergency room, even as a physician.
In both situations, we worry that those who have power in these encounters will continue to oppress us with it. We worry that they might not acknowledge the value of our lives. We worry that they may not remember there are people waiting for us to return home. We worry that they won’t acknowledge our humanity.
We worry that they will never see us.
Over this past week, my mind can’t help but race to thoughts of Sonia Massey, a 36-year-old mom of two who had called the police because of her concerns about a prowler in her neighborhood. I don’t know if she felt the same worries, and if so, she likely made that call reluctantly.
As she waited for the police to approach her door, did she also hold her breath?
What we do know is that she was brave enough to try to get the verbal agreement that so many of us think of but often never say—“Don’t hurt me.”
It was a request to let her live. It was a request to keep her family intact. A request to let her teenage children grow up with their mom. It was a request to prevent more trauma from being transmitted into her bloodline.
And like so many of us who desperately desire to be treated as human during police encounters and healthcare encounters, she was ignored.
For those of us working as service providers, whether in healthcare or law enforcement, it has become too easy to ignore those we have sworn to protect. Even with good intentions, we must not falsely believe these good intentions translate into good outcomes.
As a physician, I have had to come to terms with how much fear my presence can bring to others. So, it becomes my first and foremost responsibility to create safety. It is my role to ensure that those I interact with know that I desire for them to feel loved because that's how my patients survive, thrive, and live.
Nothing supersedes this.
Because we all deserve to live- fully, freely and fiercely.
Rest in power, Sonya, our beautiful ancestor.
I hope you can finally breathe now.
To peace & freedom for more Black girls in healthcare,
-Omolara
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