A medical student’s story of racism and bias [PODCAST]

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“I am left wondering what would have happened if I was the patient’s daughter, niece (who she said I reminded her of), or friend. The nurse made a quick judgment based on my physical characteristics, and she was completely incorrect. I am blessed to be able to challenge people’s implicit bias on a daily basis. When I walk down a hall in the hospital with my medical student badge, I feel both proud and out of place. Medicine has a long way to go in terms of making sure that people of color who are underrepresented in medicine feel comfortable, welcomed, and included wherever they go. It starts with making sure we do not make quick judgments when we see Black people and assume that they are there to take out the trash.”

Akosua Y. Oppong is a medical student.

She shares her story and discusses her KevinMD article, “A medical student’s story of racism and bias.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Akosua Oppong. She is a medical student, and she wrote the KevinMD article “A medical student’s story of racism and bias.” Akosua, welcome to the show.

Akosua Y. Oppong: Thank you, Dr. Pho. How are you doing?

Kevin Pho: Good. How are you?

Akosua Y. Oppong: I’m doing well.

Kevin Pho: So we’ll get into the article in a little bit, but first off, can you share your story and your journey to where you are today?

Akosua Y. Oppong: For sure. So I am actually an immigrant from Ghana. I was born there and moved to the United States when I was six years old. I grew up primarily on the East Coast, so I spent a little bit of time in Brooklyn, New York, and then mostly grew up in Paterson, New Jersey. Then I went to college in Boston at Northeastern University, where I majored in behavioral neuroscience, and that’s where I first developed a love for the brain.

I had always known that I wanted to pursue a career in medicine. Backtracking a bit, I actually went to a vocational high school, where I was a part of the Health Care Sciences Academy, and I think it was there where I really fine-tuned, or just developed, the passion to pursue a career in medicine. Knowing that, I then proceeded to get a degree in behavioral neuroscience, and I actually took two years off doing research at Hopkins before starting med school, working with a pediatric neurosurgeon there looking at encephalopathy of prematurity and a bunch of other research topics. Then in 2018 I started at the University of Chicago, and I have been living in Chicago ever since.

Kevin Pho: So we’re speaking in the first week of January, and of course we’re in the midst of the latest wave of the pandemic. Describe some of the challenges that you faced in medical education during COVID-19.

Akosua Y. Oppong: Right. So when COVID first started, I had actually just visited Ghana. I had gone back for the first time since moving here when I was six, and I barely made it back into the U.S. I think the Ghanaian borders closed about a week after I left. I came back to the last week of my second year of medical school, so I was finishing that and getting ready to take Step 1, which is a major board exam for us. Because of everything that happened with COVID, I was originally supposed to take Step 1 in April of last year and ended up having to take it in July. So I was in this perpetual study period, and it was really anxiety-inducing, and I was just beyond stressed, but thankfully I was able to take the exam.

Our third year was actually pushed back. It was originally supposed to start in June and ended up starting in August, so it’s been truncated. Instead of a full 12 months on the wards, we’re only getting eight months on the wards, and so we have less time to study for Step, a lot less time for patient interaction. There’s a lot less time on the wards. So far I have not really felt the effect of that, because I don’t know a time period in which we would have spent 12 months on the wards. But I think it has caused me to really value every patient interaction and value every second I spend in the hospital, because I know that it’s a shortened time period, and so I really have to take advantage of the time that I do have.

Kevin Pho: Right. So let’s transition into your KevinMD article, “A medical student’s story of racism and bias.” Now, for those who haven’t read that article, can you just walk my audience through it and share the story of why you decided to write it?

Akosua Y. Oppong: Definitely. So I think the article stemmed from the fact that I’m a Black woman in medicine, and so I’ve always known that my path to medicine will be a little bit more difficult than some of my classmates who are not Black women. This incident occurred while I was on my medicine rotation, which was the first rotation I went through. I had this patient on the heme-onc service who was just very sick, and I had developed quite a close relationship with her. She was about my mother’s age, she’s African American, and so I just felt a very close connection with her.

One morning I went in to check in on her. The room was dark. She was on contact precautions, so I had to put on a gown and everything, and I walked into the room and there were two nurses in there. One turned, looked at me super quickly, and said, “Are you here to take out the trash?” I was confused and said, “No, I’m a third-year medical student.” She responded, “Oh, I thought that you were here to take out the trash because they sometimes wear black pants.” I responded, “My scrubs are navy blue.” I think at that point she realized her mistake, and then she just started providing me updates on the patient and telling me what had gone on overnight. I said thank you respectfully and then turned my attention to my patient.

But after that incident, I realized that, and I’ve read the book by Damon Tweedy, White Man in a Black Coat, where he was confused for someone there to fix the light bulbs. I always knew things like that would happen. I just didn’t realize then. I guess I had just walked into my patient’s room on a Wednesday morning and didn’t expect that to be the first interaction I would have for the day, so I was quite shocked. I thought that it would be a great experience to write about, just to bring more attention and awareness to the racism and bias that people of color face every day, especially bringing attention to my school. We’re an extremely diverse school, so we don’t talk about incidents like this often, but I wanted to just bring more awareness to it. Essentially, that’s why I wrote the article.

Kevin Pho: So bring it back to that particular instance. What was going through your head when that nurse made that comment?

Akosua Y. Oppong: Honestly, it was just shock. I was confused. I didn’t know why she was asking me that. That would never be a question that I would think of asking anyone upon first meeting them when they walk in the room. So I was just confused as to why those were the first words to come out of her mouth, as opposed to “Hello, good morning, how can I help?”

Right when the incident happened, because I was there to take care of my patient, I didn’t think of all the connotations and the underlying message of what she had said until I went back and talked to my senior residents. We were just chatting about it, and I was like, “Wow, the only thing she noticed about me when I walked in that room was that I am a Black woman.” A lot of the people who help around in the hospital are African American, because we’re in Chicago, and a lot of the doctors are not African American. So I feel like in that moment she boxed me into one side of the health care profession rather than the other side that I truly belonged in. And it’s not that I am offended by her asking me if I’m there to take out the trash. I am not above doing that. If the trash is full, I will take it out. That was just not my reason for being there, and so I was really shocked that that’s the first thing that she asked me.

Kevin Pho: Now, was that your first experience with racism during your medical education journey, or have there been others?

Akosua Y. Oppong: I think that was the most recognizable. I think a lot of times I experience microaggressions that I don’t necessarily dwell on. One time when I was a second year, I was standing outside a patient’s room in my white coat, and it was actually a very interesting incident, because I was with my Black male classmate, and a Black male family member of a patient came out and congratulated my Black male patient on making it this far and on how proud he was of him, and he completely ignored me. So when he came back around, I was like, “Hey, I’m a medical student too,” and I think he realized what he had done, and so then he congratulated me as well. So even between Black individuals in medicine, Black women are, I don’t want to say looked down upon, but recognized less than Black men. So that’s one thing that comes to mind.

Another: Since third year has begun, a patient has yelled out of his room as I was walking by, “Nurse!” I’m like, “No, I’m not the nurse, but I can get you your nurse.” And there just have been other incidents as I’ve been going through third year.

Kevin Pho: Now, what kind of support services do you have when these instances occur? Is it something that you have to just keep within? What can you do to help address this?

Akosua Y. Oppong: Of course. So we actually have a very, very supportive multicultural affairs office, and I’m very close with the director of multicultural affairs, so I reached out to her when this happened. She actually sent my article out across the University of Chicago, and so I received a lot of support from various physicians in the hospital. There’s also student counseling services, which I use, and I tell every one of my friends to go to therapy. It’s really helpful.

But within the University of Chicago, there’s the multicultural affairs office. We also have peer ombudspersons, who are fourth-year chiefs that we can go to, and we have faculty ombudspersons who we can go to. Right now we’re actually in the works of building a bias reporting system that we can submit incidents like this to, which will bring it to the attention of the higher-ups in the institution, and action can be taken.

Kevin Pho: Now, from a more global level, taking a step back, what are some suggestions that you have to fix this as a system so these instances are less frequent?

Akosua Y. Oppong: I think, Dr. Pho, that’s going to take quite a few years. 13 percent of the residents of the United States are Black; 13 percent of the physician workforce needs to be Black in order to make sure that when we’re walking through the halls of the hospital, we are also recognized as individuals who provide care to patients. I think the other thing to keep in mind is that racism has been around for a while, and now we’re transitioning into covert and overt racism. There’s incidents of biases. We have to learn; we have to teach our kids better. It’s going to take a lot of education and a lot of work, and I don’t know that it’s something that can be fixed overnight.

I truly believe in reading and educating oneself. I think a lot of times the burden falls on Black people to educate others about the problems that we face, but I think everyone needs to pick up a book and read. I have a number of books on my bookshelf that I’m also reading to educate myself, because I wasn’t born here, and so I’m not really well versed on the history of racism in America. So I have a lot to do, and I think that everyone needs to take the steps to educate themselves and to become a lot more self-reflective and really think about what they do in their daily lives and how they can help increase the acceptance, and not even acceptance, but the inclusion of people of various backgrounds.

Kevin Pho: So what kind of books and resources come to mind that you can recommend to our audience?

Akosua Y. Oppong: Yes. So I bought Medical Apartheid. As a third year, it’s hard to read, but I plan on reading Medical Apartheid. I’m also looking, I think The New Jim Crow is a good book to read as well, so I’d definitely start with those two. But there are a number of reading lists available to individuals if they would really like to just delve into this topic and learn a bit more and figure out how they can be better and encourage their friends and families to be better as well and do better.

Kevin Pho: We’re talking to Akosua Oppong. She is a medical student, and she wrote the KevinMD article “A medical student’s story of racism and bias.” Now, for those who experience similar episodes of racism that you did, what’s your advice to them?

Akosua Y. Oppong: I think the first thing to do is really just sit and think about what happened and validate yourself and validate your experiences. I think oftentimes the first thing that we do is reach out to others, and they may impinge their thoughts and their ideas of what happened on you, and then you aren’t really able to process it the way that you would have processed it if you had just sat and thought about it yourself. So I think that’s the first step. Then certainly speak to your support system, family, friends, and in my case, actually, my seniors were really helpful, and just think about what happened and then process it again in a way that is most beneficial to you.

One of my main ways of processing was actually writing this article. It was extremely therapeutic for me, and I thank you so much, Dr. Pho, for publishing it. So you just have to find avenues, ways to, I keep using the word process, but that’s a lot of what this was for me: processing what happened and validating myself and figuring out ways to cope. That’s where I wanted to go. Figuring out a way to cope with what happened is very important, especially because it happening one time leaves room for it to happen a second time and a third time. So you have to figure out a way to cope and go about your day and not let these incidents affect you, because as a Black woman walking through the halls, I do not belong, and I feel like I don’t belong. But if I don’t permeate those spaces, no one else will, and so I feel like I have to make the first move to permeate certain spaces, and that will help me bring others along with me. I thank everyone, all the Black women before me who have permeated those spaces and made it possible for me to get to this point. And I just feel like I have to follow along that path that they have created for me.

Kevin Pho: And my final question: What is your take-home message that you want to leave with the KevinMD audience?

Akosua Y. Oppong: There are a lot of take-home messages. I have two. The first one is for women, Black women who look like me. I want to remind them that at every instance you’re going to feel resistance, but you were born to be in the space that you are in. You were meant to be there, and so just keep pushing forward and you’ll get to where you need to be, and you will feel strong and validated, and you will excel where you are.

And then for everyone who does not look like me, just keep in mind the trials and tribulations that Black women face on a daily basis, both inside and outside the hospital, and just be more cognizant as you interact with them. If you have a moment to uplift them, do that. And just keep in mind that at the end of the day, especially within the hospital setting, we are all there for one specific goal: to make sure that the patients get the best care possible. So as you work with a Black woman, or even a person of color, just keep in mind that y’all are there for the same thing, and so there shouldn’t be a reason why you are ever butting heads or ever making that person of color feel less than they are.

Kevin Pho: Well, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

Akosua Y. Oppong: Thank you, Dr. Pho. Great speaking with you.

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