hen I was in medical school, during my OB-GYN rotation, one of my classmates said to me, “Some people should not be allowed to have children.”
It was likely an offhand comment, something he said without fully considering its weight, but I felt sick hearing it. For a generation of black women in the South, this was the kind of thinking that justified forced sterilizations, and helped build a mistrust of the medical system that lasts to this day.
On Saturday, “The Immortal Life of Henrietta Lacks” movie airs on HBO. It is the story of a black woman who never gave consent for cancerous cells from her body to be used in research and, eventually, for financial gain.
I read Rebecca Skloot’s book in 2011, finishing it days before starting medical school. The themes in the story — betrayal by the medical profession and the path toward righting wrongs — forced me to grapple with this issue of trust. On the one hand, as a black woman training to be a physician, I wanted to be someone black patients could trust. But on the other hand, as I worked to join a system that had hurt so many black people, I wondered, had medicine changed enough over the years to deserve our trust?
Increasing diversity among medical providers is certainly part of the change needed to earn the trust of minority communities. For example, when patients identify with their doctors, the relationships between them are not only more trusting, but patients are more satisfied with their care and more likely to adhere to their doctor’s advice.
But as a medical student, I worried that a diversified workforce wouldn’t be meaningful without the recognition and desire on the part of my colleagues to deal with their own issues with racism.
While I was in medical school, a group of residents showed me an email from an attending physician in which the surgeon identified his patient as an “elderly colored man.”
The residents pointed out how backward this was, but I was more worried about this patient in the hands of a surgeon who saw nothing wrong with using racist language to describe him.
And my classmate from medical school? Another thing he said: “We shouldn’t be forced to treat people in the emergency room who eat themselves into heart attacks.” Black people disproportionately deal with heart disease. Where diet plays a role, many of them live in areas with little access to fresh, healthy food, and many lack the capacity to cook healthy foods.
I wouldn’t trust either doctor to have my patients’ best interests at heart.
With a legacy that includes Mississippi Appendectomies (what forced sterilization was called by civil rights leaders) and the Tuskegee syphilis study, I’m realizing we still have a long way to go.
I’m a resident now in Cambridge, Mass., and while I’ve written about the racism I’ve faced, I also see a real effort to treat all our patients with compassion. In these interactions, I see hope. I work every day to treat my patients with dignity, and to earn their trust. When I hand them off to other doctors, I know from our interactions with each other and the culture of my workplace that my patients can trust them. I trust them.
During my last year of medical school, as I was questioning my education and experiences in Virginia, I took a course called Black Physicians: History and Health Disparities. The course began with an exploration of the history of African-American physicians in the United States and subsequently focused on efforts to reverse discrimination in health care and to reduce health disparities. It was an independent study taught by a white female physician.
I saw a parallel between the Lacks family and Skloot’s quest to earn their trust to tell their story and that of this white doctor trying to tell black medicine’s story.
At the end of the course, I couldn’t help but ask why she was teaching this material. I didn’t have a single black attending physician as a clinical student, so it seemed extraordinary that I was learning this material at all. My curiosity, perhaps underscored by a little mistrust, prompted me to ask: What was her particular interest in this material? And what did she have to gain by teaching it to me?
“It’s about health and human rights,” she said.
This doctor got it — a history of not just racial discrimination, but human rights violations.
And that was an answer I could trust.