Racism in Medicine: Shifting the Power

While articles such as the February 25th, 2016 New England Journal of Medicine article "Dealing with Racist Patients," have highlighted the challenge of caring for patients with strongly held prejudices; Dr. Olayiwola's reflection in "Racism in Medicine: Shifting the Power" does something different. It sets this pain in its true context. As family physicians, we have all dealt with difficult patients. We have watched even our best efforts trivialized by a patient's disrespect. So while the frank racist actions of the patient reflected in this editorial were clearly wrong, I would argue to focus on this would cause one to miss the deeper, but perhaps more subtle pain of "needing" one's white coat for protection. This reflection does more than demonstrate the impact of racial wounds; it highlights the pain experienced when one realizes that their armor can be penetrated.

Dr. Olayiwola begins her reflection noting the tangible difference in how she is treated with and without her white coat. A mere change of clothing could not alter her essence, but it could alter perceptions. Something as simple as a garment should not make this level of impact, however minorities have born witness to several painful reminders that it does. In covering the circumstances of Trayvon Martin's death, news commentator Geraldo Rivera famously stated "I think the hoodie is as much responsible for Trayvon Martin's death as George Zimmerman was." If hoodies can make us villains, then it is not so strange to believe that white coats could make us heroes. Thus, when a black doctor is summarily dismissed on the basis of skin color alone the pain felt is deeper than the sum of its parts. It is a poignant reminder that there are biases that neither status nor education can protect you from.

Competing interests: None declared

I want to thank Dr. Olayiwola for her vulnerability in writing this powerful essay. It is difficult for physicians and especially people of color to reveal that microaggressions are often deeply hurtful. I also appreciated that Dr. Olayiwola humanized this patient while sharing her story. She eloquently and directly addressed the ever-changing nature of power and privilege that physicians grapple with.

Competing interests: None declared