“It’s a beautiful dream, stopping the wheel. You’re not the first person who’s ever dreamt it.”
“I’m not going to stop the wheel. I’m going to break the wheel.”
— “Game of Thrones”
Another day. Another Black person in America shot by police.
I should be well-equipped to deal with the emotions that arise in me every time such an event occurs. As a child and adolescent psychiatrist, I hold the emotions of others every day. I sit with patients in their darkest moments. I support them after they’ve attempted suicide. I work with others to safeguard our patient’s seemingly shattered dreams and reassure them that they aren’t alone. I deploy my expertise with words and medications to help heal their minds.
I’m also African American and gay. All of the skills forged over seven years of medical training aren’t enough to stop what happens to me every time a Black individual is shot in America. A lifetime of being Black and gay in America hasn’t made me “tougher” — it has made me more susceptible to racial pain.
So even as I internally rush to prepare my mind when I learn that the wheel to which minorities are bound turns again, I go through the dangerous emotional stages of what it means to be a minority in America who hears the chilling news about unabated racial violence.
I flatline first. It’s as if someone’s reached into my chest and pulled out my heart, leaving only an empty cavity. Society’s perpetual violence against the minoritized hollows me out time after time. I want to be able to feel something, but that wish is counterbalanced by not wanting to feel anything ever again.
The rest of the day is a wash. Most of the time I don’t fully remember the day, or the ones that follow, because they don’t seem to matter much. I become an automaton: Do this task, click this button, prescribe this medication, say these words. Run the scripts I’ve perfected. I am on-point clinically; after all, minoritized physicians must forever be perfect. Even when we are continually told by America and sometimes by the hospitals in which we work that our lives and minds do not matter in the way they should, we must still be model minorities.
The smile I plaster on hides the soul of a young man who wants nothing more than to scream powerfully enough to shatter the bigoted reality we live within.
The feeling of being flatlined is probably protective, because once I propel myself through the numbness, rage roars to life. The wrath I feel that such horrors occur over and over — and over — again replenishes the venom that had subsided since the last shooting. At times it feels like it is eating me alive as I hone and transmute my anger because to be an enraged Black man in America can be lethal — we’re killed even when we aren’t upset.
Then a feeling of defeat creeps in. I remember how, during medical school and residency, I was often not allowed to express my righteous anger. No one likes the “angry Black man.” Annoyance spirals through me when I recall how white colleagues in those years said to me, “I didn’t know things were this bad,” after minoritized individuals told them how bad things were. I want to sigh with exasperation whenever someone says to me, in essence, “If you don’t work on this, who will?” when they held the power to effect true change.
The minoritized are not the ones who caused these problems.
But I held that all in and continued to dazzle, charm, and aim to be flawless in school and at work.
Since fury is the shield of sorrow, the tsunami of mental and physical pain attempts to overwhelm me.
Every racist or homophobic experience I’ve had throughout my life tries to drag me into the past and drown me. I struggle to keep my head above the waters of previous experiences of bigotry. I do my best to support others around me going through the same experience. I’m able to do so, but it often feels like fighting a riptide.
It sounds naïve, but during these times all I wish for is a better America. When tears fall at night without my wanting them to, I yearn for us to be the country we could be. I wake up thinking how we must heal the wounds we are constantly causing each other.
To be honest, it’s this last stage I dread the most.
Why do I wish I could skip this last part if I know that feeling normal is on the other side?
Once upon a time, I wasn’t sure I’d survive the suicidal thoughts that come to me every time a Black person is killed by police. I didn’t know how I’d live through personally experiencing instances of discrimination and how such moments insidiously turned my thoughts to suicide.
These thoughts used to be very active, though nowadays they are pretty passive. I’m now able to think, “No, I don’t want to kill myself. These thoughts are coming because I’ve lived with them for a lifetime. These thoughts are coming because there is a problem I cannot solve — racism and discrimination in America — and suicide seems to be a viable solution. I will get through this and such thoughts will vanish. I can’t fix everything, but I sure can try to help out.”
They do evaporate. But that didn’t stop the fear they induced when they came this time, especially since they hadn’t recurred since I left residency. The reason those thoughts hadn’t happened since I left? Because I was finally in a safer environment after seven years of near-constant fear. My depression has been in remission since I left residency because I don’t have to go through the constant calculations of how to get through the day where some form of minority stress always arose or I’d be in fear of when bias would occur again.
After a lifetime of learning to adapt and knowing my cycle, I can now limit the process to a week. Because I’ve learned how to cope and adapt, I know what to do. But that doesn’t stop the cycle from happening.
I am far from the only person to experience these symptoms. Since the 2016 election, there has been an increase in hate crimes against minorities. Anxiety and depression in Black and Asian Americans spiked after George Floyd’s murder. Inside of hospitals, minoritized physicians and trainees are bound to the wheel as well, experiencing higher rates of discrimination across all demographics compared to white, cisgender, heterosexual males in medicine. Bigotry binds us all.
But times are changing.
This turn of the wheel felt easier than it did when I was in medical school and residency. My colleagues in my fellowship program checked on each other and spoke about feelings we all were experiencing following the shooting. We commiserated, bonded, and held each other — socially distanced, of course. One of my attending physicians and I openly discussed racism in America. Old friends from college, graduate school, and residency checked on one another and provided each other space to be open about our emotions. I feel lucky to be working in an institution that speaks openly, eloquently, and earnestly about these topics — and follows them up with specific actions to support the minoritized.
Solidarity is happening on a larger scale, too. Countries and citizens spoke out after George Floyd was murdered by a policeman. Korean pop groups like BTS and 9Muses activated their fan bases around how to help out. Inside many hospitals, health care workers, staff, faculty, and trainees began talking about the continual racism that burns out minoritized trainees and causes them to leave medicine.
We are learning to unbind ourselves from the wheel. We are realizing it’s about time — no, it’s past time — that we shatter broken systems and build a better world for us all.
And that gives me hope.
Chase T.M. Anderson is a fellow in child and adolescent psychiatry at the University of California, San Francisco.
If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.