Who is the black female? Is she lovely, sassy and strong? Who is she in comparison to the 70 kilogram white male upon which certain assumptions are made? What do I need to know about her to be an agent for her health and wellness? And furthermore, what is the tie that binds Michelle Obama, Zoë Saldana and Sybrina Fulton? Power, beauty and poverty walk with the various races and colors in a seemingly desultory manner that belies the structural violence that haunts us.
So what is the clinician to do? There is not a language barrier in the strict sense. And thus there is no “Entre Doctor y Paciente” to aid him or her. Interestingly, in certain circles, there is also the shy assumption of lack of a difference. Liya Kebedee and Carolyn Murphy are just two women for whom God utilized a different pattern to produce. Side by side they stand like a trick of the lights.
So what is the clinician to do? Let us zoom in upon an example that may aid in praxis. The Archives of Dermatology recently published an article online entitled “Hair Care Practices as Barrier to Physical Activity in African American Women.” Specific issues were delineated as to why this demographic does not obtain the appropriate amount of physical activity. How do we tackle this barrier such as it is?
Before musing comfortably about romantic Christian ideas of beauty and femininity, a question, one may ask, is if self-conceived concepts of beauty should wage war against exercise in zero-sum games. The answer, I fear, is not a new hair product. The dénouement, I pray, is not to shave off her glory (literally or figuratively). In broad strokes, the solution is change of priorities and a new vision. If I may be so bold, if smiles from reason flow, then beauty from health flows. How does a demographic not see that?
Select any lifestyle-based malady and discuss … or strategize. If Jack does not smoke, what are his reasons? If Jane has thought about cutting back on her alcohol consumption but still needs an eye opener, what are the biosocial issues that define her? The double-blind trials are not lacking. There is no want of meta-analyses. Writing the vision and making it plain, fractures and flounders under the weight and complexity that resides with women of color.
So what is the clinician to do? In addition to hunting and foraging for information about one’s patients there is always … knowing them. Is Julia to benefit from transitioning to a natural look and picking up swimming? Is Jessica’s hair a red herring, while the real issue is time management and partnership? Knowing them clarifies it a bit.
The great family physician turns 15-minute “patches” of clinic time into a quilt of surpassing beauty. A ten-minute discussion of hair may be completely ridiculous, or just what the doctor ordered.