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HANDCUFFS AND HOSPITALS: TAKING RESPONSIBILITY FOR RACISM IN MEDICINE

By Carly Muller

The first thing I remember is how small he looked, especially in comparison to the two middle-aged officers in full uniform leading him through the door of the pediatric emergency room. The officer reported, “This man is under arrest and needs medical clearance to go to jail.” I was perplexed by the word ‘jail’—surely this kid was too small for prison. ‘Man?’ —That ‘man’ was twelve years old, hardly out of elementary school, staring at the ground, his hands cuffed behind his back. I thought about my little brother, also twelve. Under no circumstance could I imagine someone referring to him as a ‘man.’ But my brother is White. This boy is Black. Both are children, and a far cry from being ‘men.’

The ED staff didn’t take his vitals because ‘they were afraid he would give them trouble.’ Some of the nurses had seen him here before, according to them, he was frequently brought in by the police. I asked the attending physician if I could accompany him to see this patient and he agreed. When we approached the bed where the boy was seated with the officers towering over him, the doctor asked, “Could you tell me how you’re feeling?” The boy, without looking up, replied flatly, “I’m not telling you anything.” The doctor looked at the officers, said, “He’s cleared,” and walked away. I followed behind him. No evaluation, no vitals, no exam, nothing.

I could go on to describe how I tried to push back, but the truth is nothing I did or said changed the outcome for that boy or the reality of the injustice he experienced.He still went to juvenile detention without a proper medical evaluation, despite a charted history of a significant medical condition. To defend my own role in this circumstance detracts from the reality that I am part of the problem. As a White woman, I participate (actively and passively) in perpetuating racial injustice, in this situation and others throughout my life. We must recognize that our lived experience in a system designed to promote racial inequity makes us complicit in perpetuating racism if we are not consciously acting to subvert it.

I read something recently in the book White Fragility by Robin DiAngelo that drastically changed my perspective. DiAngelo describes the extent to which Americans value individualism. Amidst the average, we all like to believe that we are the exception. In the face of racism, my first instinct is to defend my honor and minimize or entirely ignore my role in perpetuating racial bias. I love to think I am better than all the White people who say, “All lives matter” or “Racism doesn’t exist anymore.” I did not realize maintaining the mindset “I am above racism” means I lose self-awareness, accountability, and the ability to be an ally.

As a future medical professional, this is unacceptable. In the realm of things I can control, my own behavior lies at the center. Finally, hearing and listening to the outcry from the Black community, I know now that I need a plan to be actively anti-racist. In the last several days, I have given a lot of thought to the specifics of my plan. It is by no means complete or correct, and I know I will have to adapt it as I become more informed and travel into different phases of life. I share my plan here in hope that it may give ideas for others, but also for my own accountability:

  1. I will stop placing the burden of teaching myself about my privilege on the Black community and instead seek out ways to educate myself through lived experience, books, movies, and podcasts.

  2. I will always listen to the stories of the Black community, offer support, and create space for them.

  3. I will educate my younger brothers about racism, have conversations with them about race, and read books about racism with them.

  4. I will embrace the discomfort of calling out my friends and family whenever they knowingly or unknowingly contribute to systemic discrimination.

  5. I will remember this boy, and I will educate myself about the relationship between the medical system, the juvenile justice system, and Black children, so that I can actively oppose behaviors such as what I witnessed throughout my career.

  6. I will refuse to accept injustice and inequality, understanding that this means implicating myself in the structure of oppression.

  7. I will commit myself to the lifelong process of being anti-racist, acknowledging that it is a journey and not a destination.

Initially, I shared this story because I thought it served as an example of how our system is broken, but a friend offered me wisdom to the contrary—the system is not broken at all, in fact, it is functioning exactly as it was intended. Racism is the system, and so it does not just need to be ‘fixed,’ but rather uprooted, dismantled, and replaced altogether. It has been easy for me to reside within a structure that prioritizes my wellbeing and protects my innocence. I realize now that my inaction and ignorance are choices, and I admit to the role that I play in upholding racial bias. I hope that acknowledging this is my first step, albeit a small one, toward being a part of the solution, too.

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