December 10, 2015 marks the one-year anniversary of the inception of White Coats for Black Lives, a national organization of medical students that aims to eliminate racial bias and racism in the practice of medicine — as they are threats to the health and well-being of people of color.
I never realized
The extra weight I carried
Until I saw others
Prancing so nonchalantly
Dancing with such liberation.
But why do my feet ache
Why is my voice hoarse
Why are my eyes sore
Why does my melanin
weigh more?
Four hundred ninety-three days ago, I commenced my medical career journey eager to learn about the intricacies of the human body from respected experts, only to simultaneously be repeatedly told by the media that my own was worthless.
There were mornings when I arrived at school with drooping shoulders because I couldn’t shake off an insurmountable weight of sorrow, anger and despair. There were days when I exited the lecture hall with tear-filled eyes because I felt so powerless against the many injustices happening abroad and at home. There were nights when I found myself drinking water from the fire hydrant of medical school material while watching videos of villainous murders that would hold no weight in court. I felt defeated before even fully stepping onto the battlefield.
I isolated myself and faced the reality that my little brother or cousins could walk home from school and be shot without explanation. I improved my driving skills and increased my utilization of blinker lights so that I wouldn’t have to be pulled over by someone in a uniform I wasn’t sure I trusted. I sought a community that simply did not exist, because aside from myself, only three of my classmates, out of 186 total, identified as black. I read countless news articles and engaged in conversations about these events outside of medical school, but once I walked onto campus, I experienced this eerie feeling that all of the shootings, videos and discussions were a part of some nightmare. The silence in the hallways startled me and I didn’t know which world was worse.
And then, three hundred sixty-five days ago, medical students nationwide stood together in solidarity to protest the incessant police brutality against black people. It was an empowering moment for me to be reminded that there were other medical students deeply concerned about these issues and demanding that their grievances be addressed. A friend and I grew bright-eyed and marveled at the participation of so many medical students in the bold campaign organized by White Coats for Black Lives, which called for the equal treatment of the oppressed. “Could this happen here?” we questioned. We beamed at the list of schools but soon noted that practically all of the die-ins took place along the Northeast or the West Coast. “Would any school in our southern climate tolerate a discussion of the ‘big R word’?” Historically, professional schools have chosen reticence and neutrality when confronted with social issues — integrating the politics of the south only complicates matters further.
Three hundred and sixty-five days later, we are still watching viral videos which prove that the dehumanization of black lives is a complete joke to those we entrust with our safety. Three hundred and sixty-five days later, I am saddened that my medical education never once addressed how racism predisposes patients of color to live in polluted environments, consume higher amounts of preservative-ridden cheap food or skip out on health care to provide financially for their families. For years, the majority of our society has justified its lack of acknowledgement of systemic oppression by patting itself on the back for developing programs that only help the poor temporarily. It’s truly baffling how the field of medicine boasts of its efforts to aid the poor but doesn’t talk about how the people they seek to serve will forever be in need of these programs because they fail to actually solve anything. In medical schools, we volunteer our time and knowledge to provide free health care services and educational programs for these disadvantaged populations, but at the same time allow them to continue being impoverished and discriminated against. Of course, I think such programs for those who lack access are necessary; however, it is imperative that they be coupled with conversations and programs that aim to eradicate these inequalities from occurring in the first place.
Some in the medical field are aware that patients of color frequently receive subpar health care in comparison to their white counterparts, which may be linked to the implicit biases of medical care professionals. When patients of color do receive quality care, studies consistently show that physicians of color are more likely to be the providers. As the United States becomes more diverse, there needs to be a goal to increase the number of doctors who have evinced that they will provide the same standard of care for the now underserved patients. However, data from the Association of American Medical Colleges (AAMC) shows that compared to other races, medical schools are accepting a smaller percentage of the already small applicant pool of black students who identify solely as black. In fact, the enrollment of black males has declined since 1978. Furthermore, even when there is successful matriculation of black students, medical schools do not either adequately provide resources that assist their success or help build a sense of community for these students. There is a scarcity of mentoring programs to aid those who may not know how to successfully navigate the pathway to becoming a competitive residency applicant because they come from backgrounds where they are likely to be the first physicians in their families. I am incredibly grateful for the presence of departments of diversity, filled with faculty who stand as pillars of support and do their best to provide resources, but they can only do so much when their budgets are limited because schools prioritize other financial investments. Clearly medical schools must make it a priority to analyze and improve their methods of not only recruiting more students of color, but implementing programs to help retain them.
Earlier this year, the Medical College Admissions Test was altered to include more material from the fields of anthropology, sociology, psychology and public health in order to facilitate the nurturing of future physicians that are better equipped to provide care for their patients by considering the many sociopolitical aspects of health. While medical school curricula do make an attempt to incorporate these facets into the pre-clinical portion of education, schools across the country lump this component into one or two sessions of class. Self-selecting groups of students enroll in optional electives to better explore the interplay between race, culture and care, but there is no mandatory education that promotes the development of physicians who deeply consider the complexity of health. Unconcerned students never receive that scholarship, and their ignorance is evident when you can hear them questioning the need for organizations like the Student National Medical Association or when they promote a culture of disdain by making derogatory comments about patients at hospitals which primarily serve citizens on the lower end of the socioeconomic ladder. Medical schools allow the development of that culture by haphazardly fulfilling the minimum requirements regarding cultural competency listed by the Liaison Committee on Medical Education; they do a great disservice to their students and harm their patient population by failing in acknowledging racism and treating structural competence as a necessary skill.
In three hundred and sixty-five days, White Coats for Black Lives will stand together again, and I look forward to being joined by even more students and being able to nod to progress that has been achieved. No, discrimination will not be eliminated, and not every school will have completely improved their services and curricula. Insidious systems of institutionalized racism will remain active, and embedded biases of people will remain nurtured by the rhetoric of the media and politics, as centuries of oppression will not be completely overturned in a single year. However, it is my hope that the institution of medicine will address racism as a public health issue and aggressively pursue its elimination much like it has done for other public health problems. I hope that medical college administrations across the nation will do more than make statements on their diversity pages, but instead, sincerely take legitimate action to recruit and retain African-American, Latino and Native American students, improve the access and quality of care for that same patient population and discuss the reasons this assistance is needed in the first place.
Today, although my voice sometimes quivers when it penetrates the silence of our medical community, I am constantly encouraged by the support of fellow classmates of every ethnicity, color and creed. Although the light at the end of this tunnel seems distant, I find solace in the rainbow of medical students across the nation who have rolled up their sleeves and committed themselves to the fight for justice.
Today, I eagerly await the future which involves medical school students, faculty and administration fearlessly, intentionally and openly discussing institutionalized racism while making strides toward the establishment of a better health care system for all.
Image credit: designed by Krystle Ceasar of Kinetic Visions
Contributing Writer
Baylor College of Medicine
Joniqua Ceasar is a member of Baylor College of Medicine's Class of 2020. She is passionate about social justice within medicine and plans to engage in a career of public health. When she isn't in the hospital, you can find her working on a DIY craft project, tweeting via @rxforjustice, or snapping photos on her DSLR.