n the acclaimed movie “Hidden Figures,” the main characters — three black mathematicians who are women — struggle to be accepted for who they are and the work they do in a world that isn’t prepared for expertise and authority that’s young, female, and black. Fast forward more than 50 years, and in my experience as a first-year resident at Cambridge Health Alliance, very little has changed.
A few months ago, we were treating a patient who was not permitted food or drink because she would soon undergo surgery. In discussing her case with my attending and her surgery team, it became clear that we didn’t know when she would be scheduled, so we decided to go ahead and let her eat. I placed the order so she could have something if she wanted.
A male nurse working with me said no and would not fulfill the order. He was older and white.
I deeply respect nurses’ opinions; they spend a lot of time with patients, and their clinical instinct and experience is invaluable. I took his concerns to more senior doctors, but they disagreed. I informed the nurse that we recognized his concern, but had decided to stay the course. He again said no.
My pager went off and I used it as an excuse to gracefully exit this awkward conversation. My orders were being disregarded and I didn’t know what to do.
Recently, I was jotting down notes on medications for a patient whose lungs were filling with fluid, when his friend, a middle-aged white woman, slapped my hand.
I dropped my pen in shock and looked up at her in disbelief.
“Illegal abbreviation,” she scolded, waving her index finger at me.
As if I was a dog who had gotten into the trash instead of the doctor trying to treat her friend’s dire condition.
This woman gave me a lecture on which shorthand was allowed and which was frowned upon. She was emboldened to do so because, she said, she used to be a nurse. I simply picked up my pen and carried on.
Her touching me was especially galling because, while treating her friend, I had been careful and respectful in putting my hands on his body:
“If it’s OK, I’m going to do a physical exam.”
“May I use my stethoscope to listen to your heart?”
“If you don’t mind leaning forward, I’d like to listen to your lungs.”
Yet his friend, a former clinician, hit me. She disciplined me, as if I was a child — as if I had no authority to be in that room, caring for her friend. She put her hands on me, a stranger, without asking if it was OK.
In both of these cases, my authority and autonomy were challenged. Was it because I was young? Because I was black? Because I was a woman?
Black women constantly deal with the indignity of not being taken seriously by white people whose privilege towers over them in society. In the hospital, however, the power and privilege are mine. As a doctor it is my responsibility to make decisions that ensure my patients’ medical needs are met. As a trainee, I recognize the complexity of our conflict: outside the hospital, the power was theirs. Inside, it was mine, a young black female physician.
Maybe they preferred the status quo that kept me, the hidden figure, hidden.
In the case of the male nurse who refused to fulfill my patient order, I had to ask my attending physician to intervene.
In the case of the woman who slapped my hand, her microaggression broke both professional and personal boundaries. I felt too humiliated to tell anyone about it.
In both cases, I had to reckon with a lack of respect that went well beyond my role as a trainee. I’ve had to ask myself, when are we allies with our colleagues and the people we treat? When are we at odds? Why do I even have to ask this question at all? I have to figure out how to be a good doctor, while sorting through the social dynamics I’m subject to as a black woman. This is something I’ll have to navigate my entire career, while many other residents will grow into the respect they’ve earned, without question.
During this Black History Month, I’ve been reflecting on how my race and gender intersect with the extraordinary responsibility I have for my patients’ health. It has made me realize how I often choose to please others at my own expense because I’m trying to make them more comfortable around me and my role in the medical hierarchy.
As a physician, I’m learning that I need to lean into my authority and counter any force that threatens to undermine it, because one day I will be an attending and doctors-in-training will look to me for leadership, guidance, and support. By putting myself first, as a black healer, I truly believe I’m putting my patients first.