How is this still happening to all of us?

I often say when telling my story that I truly became Black only when I crossed the border to go to medical school. I quickly learned that America was not the melting post of meritocracy that I was promised when watching American sourced TV in which if I worked hard enough, I could be “moving on up” with a soundtrack playing in the background.

Every day and in every way, I am reminded that I am a Black woman and as such I need to act according to the rules and regulations set out to keep me in my place at the bottom of the crab barrel.

I like many foreign-born Blacks had watched from the outside and knew that there was racial tension in the US, but I was different; I knew how to work hard and how to behave myself appropriately. And I also drank the Kool-Aid of the broken American black family being the root of the problems. The cognitive dissonance was astounding as I was raised by a single black mother, but please excuse my then youth and ignorance.

Also like many foreign-born Blacks I was quick to point out how I was not African American; gone was the melodious lilt of my Jamaican birth, replaced by the Fargo like twang of the Canadian north, I was Caribbean-Canadian, and I leaned into my privilege of being light skinned, college educated and pretty.

I don’t want to misrepresent Canada as some sort of racial nirvana, the US casts a large shadow, and more things crossed the border than just fast fashion. I recall being the only Black girl in my class of gifted students; and being called out for “acting white” because I was on student council and the honor roll. But what Canada does not have is a well-organized machinery of oppression built on 400 years of economics and the political supremacy of the white race.

And while talent is ubiquitous, opportunity is not, so when I was recruited to go to an American medical school, I was happy to leave my homeland. The fact that no Black woman had yet earned the title of pediatric surgeon when I set that as my goal did not deter me (that honor would be earned by Andrea Hayes-Jordan). I was not the first, but I am one of the first 10 women to cross that threshold and I am proud of every one of them, because I know, firsthand it was not easy.

But if I wanted an easy road, I could have married my college sweetheart and been a soccer mom on Newfoundland Island. The plan was to open the door that had 400 years of white entitlement keeping it closed. To open that door and leave it open for others to walk through with their heads held high.

Now, I have been out 23+ years and I am still amazed that we still must work twice as hard to be considered half as good. Every Black child has had that speech from well-intentioned parents — the problem is that the half as good is as our white counterparts which places white as the standard.

The pervasive assumption even among our skin folk is that white people are “superior” to Black people and people of color.

Black Americans are approximately 14% of the US population but only 5.7% of US doctors are black and only 2.8% are Black women. A 2020 study in the Annals of Surgery counted only 123 Black/AA women surgeons as faculty at US medical schools with only 11 being tenured faculty. As for us pediatric surgeons, our numbers barely fill an elevator.

How is this still the case? The problem is first that the medical field has long been a white male dominated profession. When you think of a pediatric surgeon, a specialty that has only 45 spots a year for the approximately 70 to 90 applicants you are not expecting a 5 ft 9 Black woman with natural hair that still gets asked for ID when going to a bar (Black don’t crack is not just a saying). I have actually had families sign surgical consent and honestly ask me if they are going to get to talk to the surgeon before their child goes to the OR suite.

I allow them the grace of their focus being on their sick child and I take no offense. The real issue is the everyday racism of hospital staff who “mistake” me for housekeeping or the latest, the nurse who asked me if I was the patient’s driver even while wearing scrubs and an ID that clearly indicated that I was an MD.

The worst are the old guard surgeons who refuse to learn laparoscopic surgery but then sit like the Statler and Waldorf from the Muppets critiquing every move you make, giving out narcotics and antibiotics like candy and practicing medicine like it was 1952. And the cut that really scars, are other physician colleagues that sit silently and watch the persecution go down. I can only assume they are fearful for the security of their own jobs.

Post COVID, the hospitals are now policed by undertrained inexperienced nurses who make complaints out of their own ignorance, clinical deficiencies, or worse biases. If you express clinical concerns about staff training and safety, you often find yourself on the receiving end of retaliatory complaints — if not for your skill and competence then as a disruptive or abusive physician; the dog whistle of the “angry black physician”.

When these types of environments are supported by hospital leadership — the same people who heavily recruited you and promised you the world to get you on staff, it becomes a losing proposition. This often leads to physicians of color leaving the institution, some so traumatized they need profession treatment for the acquired PTSD.

And I wish these stories were, rare, one-offs in a sea of diversity and inclusion, but they are not. And what is most alarming is the secrecy either because it evokes our feelings of shame and imposter syndrome (we all have it) or that the hospitals hide behind confidentialities of “peer review” or non-disclosure agreements, so that these patterns of behavior remain unchecked, hidden to future physicians of color who may be recruited and to the outside world. Left in the wake of this deceit are the destruction of the careers of much needed physicians of color.

When I graduated from residency, I was gifted with two things I cherish, my completion certificate and a group of friends that I have kept for these 23+ years. We are each other’s professional and personal confidants and represent the diversity of medicine, Black, Asian, and Latino. They are my Green Room, and we now realize that we need to open membership — make this a place where we can all talk openly about what’s really happening in the hospitals and to each other. We know our worth and you should know yours too. How to keep yourself out of hot water and where to go if you feel targeted and alone. It’s time to start taking names and sharing our stories, because silence only aids the oppressor.