20 Quotes from Doctors, Nurses & Med Students: Revealing The Inside Story of Racism in Healthcare.

I am an immigrant physician living in the United States for the last 10 years or so. I want to reveal some of the discussions regarding racism, sexism or fascism, that happens within our healthcare system. I'll share events, gossips and experiences. These are not my thoughts but quotes from physicians, nurses and medical students exposing racism in the field of medicine. So stay with me to stop dead in your tracks!

Racism and sexism can be a societal, individual or system-wide issue. That is why it is healthy for a community to talk about it. To learn, discuss and improve.

Racism is not something unique to America. It breeds everywhere. In Pakistan, as a medical student, I encountered racism faced by my friends from Afghanistan who were seeking refuge in Pakistan at that time (I guess that has not changed). In fact, I published a medical article titled, "An Immigrant who made me a Doctor".

I have had my fair share of encounters as a Pakistani immigrant physician working and living in the US. I called these as events that made me uncomfortable. And I took it as being a part of the 'immigration intermingling process' -- until now

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Let's get started. My disclosure: these quotes and comments are not not intended to hurt your feelings. These issues impact both patients and healthcare. Kept it anonymous on purpose.

Here are the quotes from physicians, nurses, pharmacists, medical students. Take it or leave it:

1. An African American medical student reports, "As a third year medical student, I did rural Medicine in Missouri. When I walked in I was greeted with “ohhh you are black”. The whole month attending has to go in and ask if the patients would feel comfortable with me seeing them. I only saw 1-2 patients a day in a full clinic as everyone else refused." Another As an intern, got called the N word by a white patient. My white male attending immediately walked over to him and defended me, telling him he could not use racial slurs.

2. A doctor said, "Various elderly patients during my training in the mid-west refused to answer the question on "Who is the president of the US?" when I was evaluating their mental status. On one occasion, a family member responded, I am sorry to say this but my dad considers saying this name (Barack Obama) would 'blacken his tongue'. Even if he was in his sense, he would not say it."

3. During a Psychiatry rotation, one medical student discloses, " I’m a med student and it was my first day. The only black resident was out that day so when I walk in the attending says “ah so I see we’re replacing one for the other.”

4. Another physician shared, "I was in the ED (emergency department) seeing a white patient that seemed sleepy. I tried to wake him several times. Eventually he sat up in bed, got in my face, and yelled that he didn't want a Somali doc. Had to use humor to diffuse... 'You're in luck. I'm not Somali.' Lucky for me white chief had my back, but it didn't feel good.

5. An emergency medical tech reported, "One of our patients having an inferior wall MI made it a point to make sure I had a valid driver’s license because “I looked like I wasn’t from here”, as if I hadn’t backed the damn ambulance into her driveway five minutes ago."

6. A white physician shares his past experience from his training days, "In residency my Black and Jewish co-residents saved a guy with a Peckerwood tattoo who woke up and refused to talk to them, demanding white docs. The resident said, 'I'm the one who saved your life, Sir.' The patient's mom and girlfriend sent flowers with a "White Power" card."

7. A sub-intern rotating on Medicine service reveals his experience, "We admitted a new patient: middle-aged Black woman with severe thigh pain. Thigh extremely tender on exam. I asked for imaging. Supervising resident saw her, said she's hysterical, probably high on cocaine. Discharged...admitted again. Turned out it was a thigh abscess."

8. One Muslim trainee physician said, "Oh, and a nurse told me I couldn’t go into the OR (operation room) with “that thing on your head” (my hijab). Senior resident and fellow students walked away and left me to deal."

9. One medical student shares her experience, "On Labor & Delivery service, an attending doctor would consistently say black patients were exaggerating their pain and being overly dramatic. I can't tell you how deeply disturbing it was to be on that service."

10. One female doctor shares this, "I wear hijab and had a patient ask “Your husband is letting you go to Med school?” I’m not married and even if I was, I wouldn’t need permission to get an education."

11. Another women physician who wears hijab tells an encounter where a patient said, “I don’t want to be seen by a terrorist.” Have also been asked, “you’re not the type of Islam that’s going to kill us, are you?”

12. A medical student shares, "My fiance brought me lunch one day to school (which he did often). He had security called on him, a "suspicious-looking black man on campus." Thankfully he'd already made friends with the head of security at my school."

13. An attending physician in a teaching hospital reveals, "A patient refused to answer questions posed by one of my residents who is a woman and Pakistani, he told me that he does not have to talk with her. I told him he does not but that I will not tolerate his demeanor to any member of my team."

14. An African American nurse shares her experience, " One time we were restraining a combative patient. The next day he told our manager that one girl in particular laid on him and pinned him down and now he didn’t want another black nurse in the room. There were 5 other white nurses in that room he didn’t complain about. Thankfully, my manager told him he would get whatever nurse was assigned and if he didn’t like it he could leave."

15. A resident trainee tattles about an event where a patient told her attending: "I don’t want a n—- touching me. He was amazing at ignoring that."

16. A senior medical student whose ethnicity was non-white, says, "A Couple of years ago I was stopped on my own med school campus for ID check. When I asked security why the group in front of me didn’t receive the same treatment, the answer was “They look like they go here...”

17. A medical student sharing what he saw, "An older white male patient did not like the idea of having a black female anesthesiologist so asked for a white one. He was given a white male anesthesiologist, wearing a yarmulke. The look on the patient’s face was priceless."

18. A a charge nurse discloses her experience, "I once had a patient request a new RN because they didn’t trust their “African” nurse. I reviewed the chart, agreed that the RN did the right thing. Also educated the patient that all RNs have to pass the same test. Refused to switch assignments." 19. An Asian American physician shares a shocking story of hers, "My practice sent a formal apology to a patient who demanded a refund as she was dissatisfied with my care and she couldn’t understand a word I was saying because I was speaking “Chinese” First off, I’m not Chinese (there are others Asians out there) and I was born in America. English is my only language....this has to change. The status quo cannot stand. I refuse to teach my kids that this is ok 20. A Black pharmacy student tells us about his recent experience, "When I was a pharmacy tech serving a customer who was picking up photos, I asked "Are they holiday pics sir?" the reply "no, just up to no good street rats like you". I was raging. I snatched the photos back & informed the manager who promptly barred him."

CONCLUSION:

As a physician who is aware of the day-to-day racism in healthcare first-hand, I do feel there is some element of racism in all of us. Myself included. But do I try to suppress that instinctive behavior and consider it wrong? I try to.

According to Freud's model of the psyche, 'id' (wild instincts), 'ego' (mediator) and 'superego' are three necessary agents of a human psyche. Political correctness (superego = political correctness) is important to gradually clean the disgust often associated with the 'id'. As our society rids of "political correctness", the 'id' and evils get exposed. Like naked truth.

Before you judge, let me wrap this blog with a quote from a colleague, 

"All of my African American coworkers have said that they will not go to a white doctor. They seek out “their own”. Why is this always acceptable? Skin color/name/ethnicity should not matter."

Comments, thoughts?

Atif Zafar, MD is a physician, entrepreneur, and the author of the book "Why Doctors Need To Be Leaders: A Call To Action Amidst The Evolving Complexities of Healthcare". He can be reached at atif@doctorsmovement.com.

The book is available on Amazon: www.atifzafar.com/book.

Disclosure: The blog is a reflection of various quotes from healthcare providers and students. It is intended to raise a discussion and not hurt any feelings. Doctorsmovement.com takes no responsibility of the content and its implications.