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Confronting Race Issues in Medicine

As I am writing this, our nation is
mourning both the death of several police officers in Dallas, and the end of
two more young black men’s lives at the hands of police in Minnesota and
  The issues of racial
prejudice, racial distrust, and racial profiling and stereotyping affect every
aspect of American life and culture, and so medicine is certainly not an
  Despite what I would wish, I
know that I have racial prejudices, and perhaps at times my patients can sense
them. But if medicine in non-unique in its racism, it bears a special
responsibility to heal itself so it can best heal others.

remember a few years ago when I was still working in Oregon, I received the
evening sign-out from my partner as I took over the management of Labor and
Delivery for the night shift.
  In room 8,
she reported, there was an African-American woman with her partner.
  Labor was progressing slowly, and she would
need a check soon.
  My partner commented
that they seemed to have a lot of questions, and seemed a bit suspicious of her
  I went in a few minutes later,
wary of what kind of reception I might receive.
True to my fears with the patient was a young black man wearing a hoodie
with the hood shading his face in an already dark room.
  I braced myself for a potentially contentious
discussion, and asked them how things were going from their perspective.
  When the young man started speaking, I
instantly recognized his voice, and suddenly everything I thought I knew was
  Here was the graduate student
in French studies, a few months away from a PhD, my French tutor of several
years, with his wife in labor.
  They were
relieved to see me, and I was certainly relieved to recognize them.
  But in this recognition I realized how I had
pre-judged, the root of prejudice, the couple, before I had stepped into the

aware of our prejudices is certainly a first step toward preventing them from
controlling our thoughts and behaviors, and as an educator I worry when
students are unwilling to confront their own prejudices.
  I’m not sure medicine can free itself from
this illness without the rest of country participating in the project, but we
do need to recognize the effects of racial prejudice that are unique to
  Medical students have noticed,
and then questioned whether young black men receive adequate opioid analgesia
when they are in severe pain.
  In my
specialty, young black women are often suspicious of my advice and
recommendations on issues such as contraception or treatment of depression.
  This mistrust is well-founded in the history
of medicine.
  The “father” of gynecology
Dr Marian Sims performed experimental surgery on slaves without anesthesia,

and many black women were infected by the partners with syphilis while the US
Public Health Service conducted the infamous Tuskegee experiment without
subject consent or treatment even after penicillin was widely known to offer a

While our young patients are probably more affected by the racism they
experience everyday than by the history of medicine, it is our responsibility
to work hard to make the clinic a place of safety and trust for all our
patients, rather than dismiss our patients for “non-compliance.”

diversity in our police departments has probably helped in some ways, it is
clear that diversity alone is not the solution to institutionalized racism.
  Similarly, while the diversity of medical
school classes has improved during my time in medicine, it is still the
responsibility of middle-aged white men like myself to admit our prejudices,
and work everyday to move beyond them.
We owe it to our patients. Beneficent care requires seeing, and hearing,
the individual before us.
  This is turn
requires an openness whose starting point must admit no judgments before
entering the room.

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