{"id":2339,"date":"2017-09-18T20:32:59","date_gmt":"2017-09-19T00:32:59","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2339"},"modified":"2017-09-22T12:03:47","modified_gmt":"2017-09-22T16:03:47","slug":"racism-in-medicine","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2017\/09\/racism-in-medicine\/","title":{"rendered":"Beast Mode Is Back! When Actions Speak Louder"},"content":{"rendered":"
\"John<\/a>

John Junyoung Lee, MD, is the 2017-18 Chief Medical Resident in Internal Medicine at the University of Miami at Holy Cross, Fort Lauderdale, FL<\/p><\/div>\n

Cal Football<\/h2>\n

I bleed blue and gold. No, I am not talking about Michigan, West Virginia, or Notre Dame. I am definitely<\/em> not talking about UCLA Bruins (by the way, UCLA fans, a bruin is a brown<\/em> bear). That\u2019s right \u2014\u00a0I am a die-hard Cal Bears<\/strong> fan.<\/p>\n

\"\"<\/a><\/p>\n

Thanks to Cal football, and particularly to legendary Marshawn Lynch, my college days were filled with excitement. (I am counting on you, Coach Wilcox.) Marshawn, an Oakland-native running back, is one of the best football players to graduate from Cal,\u00a0and he\u00a0happens to play for my team, the Oakland Raiders. Known for his power running style and ability to break tackles, he is one of the best running backs in the NFL, and I think he makes the world a better place. You think I am being dramatic? Let me prove you wrong:<\/p>\n

    \n
  1. Marshawn blesses us with his famous unfiltered one liners. Sometimes he will grant an interview, but mainly so that he doesn\u2019t get fined<\/a>.<\/li>\n
  2. Fam1st Family Foundation<\/a>, which Marshawn helped to co-found with his relative, Josh Johnson (NFL QB), provides education and empowerment to underprivileged youth.<\/li>\n
  3. Have you ever seen anyone better at \u201cghost riding the whip<\/a>\u201d?<\/li>\n
  4. Marshawn Lynch sat down<\/em> during the national anthem at Raiders preseason game against Arizona Cardinals. Judging by the national uproar that followed, actions still speak louder than words. Just ask Marshawn about it. Oh, wait\u00a0\u2014 he might not answer your question.<\/li>\n<\/ol>\n
    \"\"<\/a>

    Aug 12, 2017; Glendale, AZ, USA; Oakland Raiders running back Marshawn Lynch (24) prior to the game against the Arizona Cardinals at University of Phoenix Stadium. Credit: Matt Kartozian-USA TODAY Sports<\/p><\/div>\n

    Marshawn did not immediately elaborate on his action, but his sit-down happened in the wake of the violence at the white supremacist rally in Charlottesville and followed Colin Kaepernick\u2019s protest against racial injustice and police brutality against people of color. Marshawn\u2019s simple action, or inaction, polarized the football community\u00a0and ultimately achieved its intended purpose: to sustain and stimulate conversation about what happened at Charlottesville and across the nation.<\/p>\n

    When pressed by the media about his anthem sit-down, Marshawn said, \u201cSo my take on it is, $#!t has to start somewhere, and if that was the starting point, I just hope people open up their eyes to see that there\u2019s really a problem going on, and something needs to be done for it to stop. And if you\u2019re really not racist then you won\u2019t see what he\u2019s doing as a threat to America, but just addressing a problem that we have.\u201d<\/p>\n

    Racism <\/strong><\/h2>\n

    Individual and structural, overt and implicit\u00a0\u2014 pervades every state and every industry, and medicine is not immune to it. While we doctors use objective measures, such as lab tests, to diagnose patients’ ailments, we also use heuristics in our medical decision-making, depending on our categorizations of people based on physical characteristics, such as race and ethnicity. And sometimes, a patient\u2019s race becomes a confounder:\u00a0A black patient\u2019s pain is treated differently from a white patient\u2019s pain.<\/p>\n

    The patients also bring their own biases and stereotypes to the hospital. A typical male Floridian octogenarian, meaning a white-haired transplant from New York or a \u2018snow bird,\u2019 presented to our emergency department for acute heart failure exacerbation. He was huffing and puffing until we put him on a noninvasive positive-pressure ventilation. Remarkably, between his gasps for his next breath, the patient managed to point at one of our residents of Middle Eastern heritage and to spurt out the following string of words: \u201cI\u2026 Don\u2019t Want\u2026 His Kind\u2026 Treating Me.\u201d It was a paradigm of how not to start a vulnerable yet trusting relationship between a patient and a physician.<\/p>\n

    The story might seem to show\u00a0an isolated incident, but our hospital has been getting such requests, with increasing frequency, in the past few months. Why? We are not sure, but we know that since the last presidential election in the U.S., there have been multiple reports of racist- and hate-fueled harassments and acts of intimidation around the country.<\/p>\n

    How Do We Fight Racism?<\/h2>\n

    How do we approach such a sour situation in medicine?<\/p>\n

    Our duty as physicians is, first and foremost, to treat and to stabilize patients. Once patients are stable, those with competency have the right to refuse care under informed consent. In other words, patients can refuse care from unwanted physicians. In turn, physicians are also freed from our Hippocratic Oath to \u201cconsider for the benefit of my patient and abstain from whatever is deleterious and mischievous.\u201d It would be deleterious and mischievous to force a professional relationship that was built on bigotry.<\/p>\n

    While letting patients choose physicians based on race, ethnicity, gender, or sexual orientation seems like allowing hate to win, stepping away from the \u2018fire\u2019 helps physicians to protect themselves from unwarranted verbal assaults and constant emotional abuse. Physicians are allowed to acknowledge their human emotions, too.<\/p>\n

    We must perform our duties as physicians, but we do not have to tolerate hate. I recommend physicians to remove themselves from hurtful encounters, but\u00a0I also encourage physicians to advocate for, or at least try to understand, someone from a different background. Unfamiliar does not have to equal uncomfortable: See it as a learning opportunity. After this blog, I might even become\u00a0the recipient of\u00a0racially charged comments. I am, however, willing to embrace whatever comments\u00a0are directed at me. Why? Because that\u2019s exactly what this is about: to break bread and generate conversations as a way to break barriers and hate. And besides, I could not turn down an opportunity to write about Beast Mode<\/strong> in the New England Journal of Medicine<\/em>.<\/p>\n

    Go Bears!<\/p>\n

    \"\"<\/a><\/p>\n

    p.s. Marshawn, holla back at your boy! Maybe when Raiders come to play Miami Dolphins in November?<\/p>\n

     <\/p>\n

    \"NEJM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    Cal Football I bleed blue and gold. No, I am not talking about Michigan, West Virginia, or Notre Dame. I am definitely not talking about UCLA Bruins (by the way, UCLA fans, a bruin is a brown bear). That\u2019s right \u2014\u00a0I am a die-hard Cal Bears fan. Thanks to Cal football, and particularly to legendary […]<\/p>\n","protected":false},"author":1287,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,1],"tags":[117,109,115,111,19,116,110,114,118,31,113,112,119],"class_list":["post-2339","post","type-post","status-publish","format-standard","hentry","category-miscellaneous","category-uncategorized","tag-berkeley","tag-cal","tag-cal-football","tag-colin-kaepernick","tag-communication","tag-go-bears","tag-marshawn-lynch","tag-medicine","tag-oakland","tag-patient-care","tag-racism","tag-racism-in-medicine","tag-raiders"],"yoast_head":"\nBeast Mode Is Back! 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