I immigrated to America with my siblings and mom in the summer of 1998. Three years later on April 7, 2001, when I was a freshman in college at the University of Cincinnati, the Cincinnati Police killed an unarmed Black teenager named Timothy Thomas, igniting several days of protests. That was the first time I came face-to-face with the cruel reality of racism, police brutality, and violence against the Black community in America. After Timothy Thomas came many others. Sean Bell. Oscar Grant. Trayvon Martin. Rekia Boyd. Eric Garner. Michael Brown. Tanisha Anderson. Tamir Rice. Walter Scott. Freddie Gray. Sandra Bland. Samuel DuBose. Alton Sterling. Philando Castile. Stephon Clark. Atatiana Jefferson. Breonna Taylor. Ahmaud Arbery. [and many, many more…]. And most recently, George Floyd- who like his 6-year-old daughter Gianna said while sitting on the shoulders of one of her father’s best friends, retired NBA player Stephen Jackson, her “daddy changed the world”. The world watched in horror as a police officer kneeled on Mr. Floyd’s neck for 8 minutes and 46 seconds as he pleaded for his breath, killing him on May 25, 2020. Protests erupted all over the world.
I wish I knew the answers. I wish I knew how to change the world. I wish I knew how to change the reality of being Black in America. What I do know is that this time it feels different. This time I am hopeful. This time I have witnessed people speaking up who never speak up. I have seen hearts shattered all over the world and emotions exploding across every continent. Systemic racism is a disease in America and the system needs dismantling. Change can no longer wait.
Why did I say we needed to talk, doctors? Because we desperately need to. Violence, police brutality, and injustices against the Black community are a public health crisis. How do we expect to talk to Black patients about blood pressure and glucose control without addressing the trauma Black women and men experience on a regular basis living while Black in America? We took an oath, to serve mankind, now is our time to step up like we have never stepped up before. This is not a bipartisan issue; this is a human issue.
Academic and non-academic medical institutions all over America kneeled on June 5, 2020 in remembrance of Mr. George Floyd after they issued statements (ranging in directness of messaging) denouncing his soul-crushing murder. While this display was profound, we cannot stop there. We must move past the vigils, remembrances, thoughts, and prayers, emails, diversity and inclusion workgroups, and committees, and meeting after meeting after meeting, to the implementation of initiatives that dismantle the systemic racism ripe in medicine. Black women and men are grossly underrepresented beginning in medical school all the way to professorships, tenured positions, chiefs of divisions, and medical school deans.
I do not know all the answers, but I do have some suggestions:
- When you get invited to speak at a school about being a doctor, rather than feel good for the day and add it to your curriculum vitae, connect with a Black student or 2 that may be interested in medicine and mentor them. Find out if your institution has a summer program for minority students interested in medicine and get them connected. Maintain a relationship with them and guide them through their journey in medicine. You may be the only person that has made them feel like they belong in medicine and that their dream is within reach.
- Recruit Black women and men into your residency and fellowship programs and mentor and sponsor them throughout their training. If they are interested in research, provide them with opportunities to work with your team. Amplify their voices and work on the national and international stages you have the privilege of presenting on. Recommend them for local, national, and international committees. Recommend them for speaking opportunities. Connect them with your colleagues and friends at other institutions during their job searches.
- Recruit Black women and men into your institutions and work hard to retain and promote them. Recommend them for leadership positions. Guide junior faculty in their research efforts and put them on your grants. Cite their work. Get them to the podium on national and international stages. Invite them to meetings where big decisions are being made. Recommend them for local, national, and international committee positions (other than the cliché “Diversity and Inclusion Committee” positions). Recommend them for promotions and tenure.
- Let go of the idea that Black patients are the responsibility of safety net hospitals alone. In any given city, there are more Black residents than what a single hospital can handle. Go into Black communities and build relationships and welcome Black patients into your hospitals. If Black patients say they are not comfortable being cared for at your hospital, then you desperately need to change the face of your hospital.
- Which brings me to my next point, diversifying your hospitals means diversifying the faces from environmental services, valet, and food services all the way to division chairs and hospital presidents.
- Speak up right then and there, every single time, in defense of your Black students, trainees, and colleagues when discrimination occurs in your presence. And defend them when they are discriminated against when they are not present.
Nothing seems to have changed since I immigrated here in 1998 but I do feel that this time is different. My fellow doctors, this is not the time to watch from the sidelines. It is not the burden of Black doctors to dismantle the systemic racism that plagues medicine. Use your privilege to act, I promise you will not lose it. When this wave of protests, kneeling, and anti-racism training settles, I want us to remember those horrific 8 minutes and 46 seconds and remember the role we each must play in dismantling systemic racism.
Rest in paradise Black Queens and Kings. We will not let up.
Black Lives Matter- today, tomorrow, and forever.
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Nasrien E. Ibrahim, MD is an assistant professor of medicine at Harvard Medical School and an advanced heart failure and transplant cardiologist at the Massachusetts General Hospital. She is interested in biomarkers, cardiac remodeling, access to healthcare, understanding mechanisms of health inequities, and women’s leadership in academia. She loves college basketball, hip hop, the beach, and LeBron James. You can follow her at @DrNasrien