As a Black woman, I was told not to pursue a career in medicine. The path must be easier for others.

 


Andria E. Tatem, a practicing pediatrician at Texas Children’s Hospital, is a clinical postdoctoral fellow in academic general pediatrics and an incoming assistant professor of pediatrics at Baylor College of Medicine.

At 3 years old, I told my mom I wanted to be a pediatrician and “take care of all the sick babies in the world.” I knew that I was smart enough; I was already reading and on an accelerated academic track. But I didn’t know that being a poor Black girl — and, later, a Black woman — would threaten to derail me at every turn.

Now, I practice academic medicine at a prestigious children’s hospital and have accepted a tenure-track position at a prestigious medical school. But Black women are being targeted in academic medicine, and I am angry. You should be, too.

Being told “no” has been a theme in my life. At my predominantly Black elementary school, I was encouraged to realize my dreams. But when I started middle school at age 9, there were significantly fewer Black students, teachers, and administrators, and the messaging changed. I will never forget the White male guidance counselor who told me that a young Black girl shouldn’t try so hard — that I should strive to be a nurse so that when I failed to become a doctor, it wouldn’t hurt as much.

Fortunately, my mother and grandmother taught me to respond to naysayers by working twice as hard, being twice as good, and accepting half the recognition. I did this throughout high school when my college aspirations were continually challenged, even though I graduated at 16; throughout college at a historically Black university, when the pre-med advisers — all White — discouraged me from applying to medical school; when I had to fight my way off the medical school waitlist despite my sterling application; and throughout medical school and residency, when too few colleagues and mentors looked like me and my outsider status was cemented. When, in my first semester of medical school, my biochemistry professor told me that I wouldn’t survive because I’d attended an HBCU and therefore received a subpar education, I felt doomed before I’d even begun.

Now, I’ve “made it.” But I regularly wonder how long I’ll be able to work in this field as an outspoken Black woman. Tulane University School of Medicine dismissed Princess Dennar, a Black woman, as director of the school’s internal medicine and pediatric residency program shortly after she filed a racial discrimination suit with the school. The school has stated that her dismissal had to do with the program’s accreditation being placed on “warning status,” but that warning status was lifted before she was removed as director. Similarly, Kaiser Permanente Bernard J. Tyson School of Medicine suspended Aysha Khoury, a faculty member, after she facilitated a classroom conversation about racism and medicine. The school claims the suspension had nothing to do with that conversation but hasn’t offered any other justification.

Is it worth it if I’m constantly worried that I’ll be next? Yes, it is. I refuse to be a domino in an insidious chain. Fewer Black medical students mean fewer Black doctors, fewer Black professors — and fewer Black medical students all over again. Today, Black women make up only 4.6 percent of all med students in the United States, while Black men make up only 3 percent.

Making it painful or impossible for someone to pursue their purpose is wrong on its face. But for abiding racism in health care also means inferior treatment — and preventable suffering and death — for Black patients. For example, the Harvard Business Review has chronicled research suggesting that Black men are more likely to undergo medical treatment prescribed by Black doctors, while Forbes recently noted that the maternal mortality rate for Black mothers is 2.5 times that of White mothers and that physicians are less likely to prescribe pain medication for Black patients than White patients.

I am a pediatrician and a medical educator because it is my calling. Every day, I care for sick children and show my Black patients that they matter, that their families deserve respect, and that they, too, can be doctors if they so choose. I will be a professor to help the next generation do better. I am thankful that my employer values my experience, perspective, and voice, and allows me to make “good necessary trouble” without fear of retribution. This doesn’t mean that the “you’re not good enough” from my past or the shadows of silenced Black female doctors don’t haunt me every day. It just means that I keep going anyway.

Now, when I pursue my passions — teaching anti-racism workshops, incorporating social justice into our residency curriculum, implementing diversity conferences, doubling the number of under-represented-minority residency applicants interviewed — I am rewarded instead of discouraged. My patients and mentees are better for this. We must make the road I’ve traveled easier so that others will be better for it, too.

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