Tuesday, July 20, 2010

Racist Patients

"I'm just not used to all the N**gers touching me"

Recently we had a minor from the Deep South travel to the clinic where I work. I work in a clinic whose staff is a majority women of color and two-thirds of our doctors are also people of color. It was obvious from early on in her visit that this woman was slightly uncomfortable. I am one of two white staff members, and the other was out on vacation during this patient's two-day visit. She seemed scared and obviously responded to me better than anyone else despite the fact that I am not a clinical staff member. After being sedated she didn't want help getting dressed or getting to the recovery room, because it meant more people of color touching her. The patient's health and safety has to be our number-one priority regardless of her overt racism.

White women often come into our clinic and inadvertently direct their eyes at me when they ask questions, even though the woman of color standing next to me might be the person with the best answer to their question. Its often difficult to balance validating my co-workers' knowledge and ability with the desire to make the patient comfortable no matter how prejudiced or ignorant she might be. We have lots of women travel here from many places, including rural areas where overt racism is alive and well. I don't believe there is ever a justification for white people to use the "N" word. Really no one should, but that's a complex issue that I don't feel equipped to analyze.

The other women in the clinic where I work were appalled by this patient's overt verbal racism, and so was I. And there are so many other white patients who don't use such overt language to assert their racist attitudes. So often white women ask me questions, or try to get answers from me, or in some way validate my authority over other staff members. I find it really hard to figure out how to respond in those instances. I want to challenge other white people to realize the way racism operates in very inadvertent ways. I want them to realize racism is embedded in the assumed validation of my authority over a woman of color who has worked in the clinic for 20+ years.


  1. That's just gross. But again, it's all about the woman, right?

  2. We had a patient once who had lams put in, and then demanded to have them taken out once she found out the doctor who would be performing the procedure was black. It was stunning - everyone in the clinic was a little shell-shocked for a while. We are in New England where racism certainly still exists, but tends to be subtle rather than overt. What was really shocking, beyond the racism, was that she was willing to put her health and safety on the line to avoid having this doctor perform the procedure - we had to go over the risks with her, and make sure she understood that the dilator insertion had begun her abortion process, and she was at risk of miscarriage or premature delivery if she chose to continue the pregnancy. Didn't matter to her. She said she would go elsewhere.

    The other part that was difficult was that some of my co-workers seemed to feel that her racism meant she didn't have the same rights as other patients anymore. One of them acted really inappropriately in my opinion and probably violated confidentiality in her response to the patient, in front of other patients. I could understand her ire, of course, but being racist doesn't mean patients lose HIPAA rights! We still have to be professional and appropriate - and above all, respect our patients' confidentiality, privacy, and right to high-quality medical services!

  3. Its hard when patients are disrespectful and yet we must still respect them and treat them with courtesy and professionalism. I've had similar experiences where a patient would prefer talking to me because I'm white and felt bad for my African-American male attending. Or other times when I was rejected because the patient didn't want "no Jew" touching me and that I looked "too Jewish". Its not a behavior that expect from those we help. Sometimes, when I have time--or feel brave-- I try to probe as to what happened that made them this way. On more than one occasion, I've had to turn patients away as I feared that they might become litigenous. As the only doctor there, they had to reschedule.

  4. As appalling as overt racism is, especially in the 21st century, in a medical setting the needs of the patient are, as you suggest, the priority. However tempting it may be to correct her wrong-headedness, you and your colleagues are taking the higher road by being compassionate, professional and nonjudgmental.

    In our area, we are witness to homophobic, racist and ethnic comments from protesters (NOT inside). I've never heard any protester use the N word but I've heard them call escorts Jew boy or fag boy or stiff-necked Jew. And, I might add, that these wretched comments come out of the mouths of people toting rosaries. Go figure.

  5. So far, this has been one of the hardest things about being a medical student--realizing the 'wanting to help people' desire can't be qualified, even with patients like the one you describe.

  6. This is always a challenge in medicine. Although it is difficult, we sometimes do have to take care of people like this (although it's quite rare). In the end, they need to make the choice between having a safe procedure done by a competent provider or going elsewhere.

  7. Wow, thank you all for these stories. It's so damn frustrating, isn't it? Your duty is to support a woman throughout her experience in your clinic, but it can be hard to do when she is deeply upsetting you and your coworkers. But you always hope that maybe they will get over themselves and their racism (or, for another example, their anti-choice-ness!) if they get through their appointment and realize that they were treated competently and professionally by everyone there and are doing just fine now. But of course, that doesn't always happen; Lily, I am still slack-jawed at your story about the lam'ed patient, that's insane.


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