I believe that a physician’s job is to relieve suffering. To be a doctor is to be a shepherd for people, guiding them in comfort as they move through all states of life. While we can’t control all the factors of life, doctors have a role in making sure patients have a “good death.”
In my palliative care class, I learned how to do just that. With careful titrations of pain medications, anti-depressants, and the beloved senna and PEG, I know how to relieve my patient’s physical pain. I know how to utilize NURSEs phrases to portray empathy, how to have goals of care conversations, and how to incorporate our chaplain colleagues in an effort to relieve emotional and spiritual suffering. I have learned the medicine, the emotional intelligence, and the tools of spiritual healing that we use as physicians to guide our patients into having a “good death.”
Yet this morning, on the day of George Floyd’s death, I woke up to my social media pages filled with far too many “bad deaths” (well actually, murders), to count. A Black man hunted in the streets, throat crushed by the unyielding weight of police officers. A Black woman shot and killed in her own house.
I listen to my mom weep. I watch as my younger brother stares out the window, too afraid to go out for a run. I sit with my friend as he searches Amazon looking to buy a bulletproof vest so that he can once again feel safe leaving his home. I think about the thousands of Black people disproportionately affected by COVID-19, dying alone in the hospital right now.
I see the suffering of Black people. I see the “bad deaths” of Black people. I see myself, a Black person.
I believe that a physician’s job is to relieve suffering. To be a doctor is to be a shepherd for people, guiding them in comfort as they move through all states of life. While we can’t control all the factors of life, doctors have a role in making sure patients have a “good death.”
So, what is medicine doing about these “bad deaths”?
I look at my #medtwitter timeline, expecting support, outrage, something from my colleagues in medicine. I check my inbox praying my medical school has said something about this. All I see are the tears of my Black brothers and sisters in medicine. This is followed by memes about USMLE canceling Step 2 CS, a journal article about an innovation in healthcare, another invitation to a lunch talk. Mostly, I hear the sounds of deafening silence from my medical community.
But am I surprised by this silence of medicine? No. Medicine has a long history of silence when it comes to anti-Black racism and an even longer history of creating and perpetuating the anti-Blackness that has fueled our country. Medicine has infected Black husbands and dads with syphilis,1 stolen cell lines from a Black mom,2 and sterilized Black girls before they could even become those Black mothers they steal from.3
Several studies have shown that many doctors and future doctors alike don’t believe that Black people feel as much pain as their white counterparts.4,5,6 If doctors, the experts on all things bodily, can’t see our pain, how can we expect police officers, neighbors, or anyone else to?
Maybe that’s why they don’t understand us as we scream “I can’t breathe.” Maybe that is why shooting us 10, 15, 20 times to stop us in our tracks is deemed acceptable. Is it because medicine wrongly has convinced itself that we have thicker skin? Maybe that is why it is seemingly okay that so many of us are dying from COVID. And, as the medical community remains silent on all of these matters, they, once again, fail to recognize that Black people in America are experiencing serious pain.
As a future physician, I was taught very well how to relieve physical suffering, and even emotional suffering to some degree. But it is not enough to do our job of a physician in relieving suffering. We have to not only be taught, but also learn about the inequality and oppression our patients face, so that we can begin to know how to relieve the historical sufferings that are beaten into their bodies. We have to do research and create science that does not perpetuate the lies of race-based medicine that continue to harm and oppress our patients. We have to learn how to be advocates and how to create systemic changes that relieves the future suffering of our patients. We have to learn to speak up.
“Do no harm” we all vow.
As Audre Lorde said “Your silence will not protect you.”7
So please, stop doing the harm of staying silent.
Speak up. Read. Advocate. Fight. Relieve suffering. Be a doctor.
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1. Tuskegee Study – Timeline – CDC – NCHHSTP. Published March 2, 2020. Accessed May 31, 2020. https://www.cdc.gov/tuskegee/timeline.htm
2. Henrietta Lacks’ ‘Immortal’ Cells | Science | Smithsonian Magazine. Accessed May 31, 2020. https://www.smithsonianmag.com/science-nature/henrietta-lacks-immortal-cells-6421299/
3. M. A. E and CLS, B. A. E. U.S. Government’s Role in Sterilizing Women of Color. ThoughtCo. Accessed May 31, 2020. https://www.thoughtco.com/u-s-governments-role-sterilizing-women-of-color-2834600
4. Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016;113(16):4296-4301. doi:10.1073/pnas.1516047113
5. How we fail black patients in pain | AAMC. Accessed May 31, 2020. https://www.aamc.org/news-insights/how-we-fail-black-patients-pain
6. Disparities Between Black and White Patients with Cancer Pain: The Effect of Perception of Control over Pain | Pain Medicine | Oxford Academic. Accessed May 31, 2020. https://academic.oup.com/painmedicine/article/6/3/242/1837356
7. Your Silence Will Not Protect You Essays: 9780995716223: Amazon.com: Books. Accessed May 31, 2020. https://www.amazon.com/Your-Silence-Will-Not-Protect/dp/0995716226
Olivia Familusi is an MS3 at the Perelman School of Medicine. Olivia can be reached by email at [email protected].
