I entered the office of the Community Health Council of Wyandotte County, Kansas City, on a muggy, late-summer day during my family medicine rotation. The air-conditioned building boasted a large front room with sporadically placed desks, children’s books and toys, and what looked like a large food pantry. I flexed my elbows and wagged my arms to fan out the sweat from my Black body enshrouded in my white coat.
We will recall when, during the summer of 2020, the moral and political duty to engage with the most momentous anti-racist movement since the 1960s reanimated a nation paralyzed by fear. By the fall, cataclysmic wildfires on the West Coast poisoned the air from San Francisco to New York City. Coronavirus, cultural upheaval and manifestations of climate change all bore down on us as we entered the most consequential and divisive national election in living memory.
Mercedes drove two hours to the nearest healthcare clinic to get her first physical exam in ten years. I met Mercedes while shadowing a primary care physician, Dr. L. In the clinic, Mercedes divulged to me how nervous she had been driving in – she knew what the meeting held in store. Her fears were confirmed: just five minutes into her exam, Dr. L advised her, “Mercedes, you have to lose weight.”
Failure was never an option for me. // Every time I fail… / I am reminded that I have let my country down.
Send us the broken, the battered, / “give me your tired, your poor,” / your torn and tattered.
I wish it were different — / Dying patients, struggling hospitals, overworked health care workers, / topsy-turvy economies, politicized safety precautions, and the / uncertainty / of tomorrow.
Medicine is a discipline that claims to be based on empirical and scientific truth about human nature. Instead, its knowledge and practice are often steeped in biases like racism. For example, medicine was used in the nineteenth century to justify slavery due to the “biologically inherent superiority” of White races.
As I grew up, I felt these lines and had a vague idea of where they lay. I knew where in Louisville I felt “safe,” and I also knew where the “bad parts of town” were located. The lines and their forced labels serve to enhance the lives of some people, myself included, while limiting others. Two cities exist within one border separated by an undeniable feature — skin color.
But we should not need to view videos of Black individuals suffering or in pain in order to mobilize. Others, unrecorded and alone, die by the hands of our state. It is time for Americans to turn their gaze away from violent images of Black death and inwards to consider the invisible and not-so-invisible ways we uphold white supremacy every single day.
The histories of Fox Point and Brooklyn reveal how where we call home is deeply intertwined with identity, power and privilege. They tell the story of structural racism — a patterned, “normative, sometimes legalized” process by which communities of color are marginalized. The sequelae of structural racism have dire health implications at the neighborhood-level.
A recent publication in the Journal of Neurology caused significant outrage not only within a forum dedicated to Black doctors and trainees, but also in the medical community online at large. Much like the rest of the readers, I was deeply troubled and did not understand the purpose of the article.
When I first read that the Northam picture came from a medical school yearbook, I thought about whoever might have been his Black classmates at the time.