Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
“I am a woman of history who stands up and tells the truth, irrespective of what other people say. I remember the words of the late Representative John Lewis, ‘Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of a day, a week, a month, or a year. It is the struggle of a lifetime. Never, ever be afraid to make some noise and get in good trouble, necessary trouble.’
Black female physicians are not OK, but it is our collective duty to do something about it. It is our collective duty to go against the tide. It is time to take a stand and institute change that we need to initiate ourselves.”
Tomi Mitchell is a family physician.
She shares her story and discusses her KevinMD article, “The unique agony of being a Black female doctor.”
Did you enjoy today’s episode?
Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!
Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.
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 we welcome back to the show Tomi Mitchell. She is a family physician in Canada, and she wrote the KevinMD article “The unique agony of being a Black female doctor.” Tomi, welcome back to the show.
Tomi Mitchell: Thank you, Kevin.
Kevin Pho: So we’ll get into the article in a little bit, but for those who didn’t get a chance to listen to our first episode, can you just briefly share your story and journey to where you are today?
Tomi Mitchell: So I’m a board-certified family physician currently practicing in Canada. I am also a mental health and wellness coach and an advocate for social justice, and that was born out of my own personal experiences in the health care system, as a worker, a provider, and also as a patient receiving care in the health care system. So my desire is to share both sides of the story and advocate towards change and improvement.
Kevin Pho: So tell me about your activism in social justice. How does that influence you as a physician?
Tomi Mitchell: Well, definitely. I am many minorities in one. I’m a female Black physician who has experienced the inequalities that we all know are there, from an early age and more recently as an adult. And it’s definitely a vulnerable position when you are desiring care. I know I only go when it’s absolutely necessary. I don’t go just because, like, I have a cold or something. These have been life-changing situations.
And just seeing how health care delivery can vary from one place to another, from one provider to another, all of whom took the same oaths I took, it leads me to a lot of questions. And also, when I see those who don’t even have a quarter of my experience and knowledge as a physician, how are they going to advocate for themselves if they don’t know that what they’re going through might actually be catastrophic for them? I’ve chosen to be a voice for those who feel voiceless.
Kevin Pho: So give us a story or example of how your activism gives a voice to the voiceless.
Tomi Mitchell: Even though I might be female and Black, I also have a privileged position as a physician, and I am blessed to have the unique training I have. So that gives me a place of, in some ways, immediate respect and some degree of authenticity. There are apparently three professions that people trust the most: Number one is a firefighter, number two is a nurse, and number three is a physician. So we do have a very important role in health care delivery, and we make a huge impact, whether physicians, nurses, PT, OT, whoever it is in health care, on the lives of the patients and their families.
Kevin Pho: All right. So let’s transition into the KevinMD article that you wrote. It’s titled “The unique agony of being a Black female doctor.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?
Tomi Mitchell: I wrote it because I was at a place of pain and frustration where, for lack of better words, I was tired of being muzzled. I wrote it as 2020 was a traumatic year, where I had near-death experiences, for myself and my daughter, on multiple occasions. And I truly experienced my “I can’t breathe” experience for her, where my three-day-old stopped breathing. I had to do CPR on my child. Thank God I had the skills and I was able to revive her.
I took her to the hospital. She was admitted to the peds ward, and I watched her like any other mother would do, and I saw her sats desat from 99 to as low as 51 on six separate occasions while in the hospital. Imagine, post C-section, four days. I went to ask the nurses. I said, “My child isn’t breathing. She’s seizing.” They told me, “She’s fine. It’s just reflux.” And they even changed the monitor. I said, “My child is not breathing.” “Oh, it’s fine. It’s just reflux.” And they knew I was a physician too, and they knew I’m a mother, because when I was admitted with my daughter, they said, “Oh, you’re Dr. Mitchell,” and my heart sank, and I said, “Yes.”
That is one of probably a dozen experiences I’ve had, and it’s sad that one has to truly beg. In my case, I was able to call a female physician who happened to be Black and told her what was happening, and she’s like, “Oh my goodness, is the doctor on call?” No, because the shift change happens around eight. And I said, “No, because they haven’t called anybody, and I’ve asked.” And then she called the attending.
And then, pretty much after 12 hours of this agony, my daughter was finally admitted to the ICU. And at that point, I was able, uncomfortable, to leave my child unattended. I went to the bathroom to relieve myself, and I ended up hemorrhaging. So I had a massive PPH and became a patient, and that repeated multiple more times over the next two weeks, as my child was admitted from one unit to another, one city to another, because of her health.
So the point is, as providers, we need to listen to our patients. It shouldn’t take six times for you to call for help. And even with the physicians in my care, when I would say, “OK, I had a postpartum hemorrhage in my first pregnancy,” and I had five after the second, and that was delayed, because it was four days after I delivered. And I remember asking for certain medications, which I knew had saved my life before, and they were saying, “Oh, no, we’re going to wait.” I’m like, “Please.” And they’re like, “Why are you crying?” I’m like, “Because I don’t want to die.”
At this point, I was hemorrhaging so much, I had clots the size of my hand coming out, and a stick under my hand coming out of me, shaking. And I remember the nurse saying to the other nurse, when they came back, “Don’t even bother putting a pad on her. She just soaks them through.” I felt worse than a dog, because I know we treat our dogs better.
Now, I’m not painting the brush and saying all health care systems are like this, all hospitals are like this, but it’s a recurring theme that we women of color experience, and it’s well documented. And it doesn’t matter your education status or socioeconomic status. It’s there, and it’s a problem.
Kevin Pho: Now, after you went through these traumatic experiences, did you get an explanation from the hospital medical staff as to why they didn’t listen to you?
Tomi Mitchell: I got zero. I got zero apology, zero acknowledgment. And so, again, it’s traumatic. “I am sorry” goes a long way. Now, if you’re repeating the same thing and saying “I’m sorry” every time, it just means it’s lip service. But I mean, I’ve decided to take another route, and I’m being more vocal about this, because I see my daughter, who basically didn’t have oxygen supply to her brain. I see the struggles that she potentially is going through, and I can’t just stay silent.
And then, not to mention, May 25, I think it was, last year, with George Floyd begging for his life, “I can’t breathe,” and begging for his mama. When I first saw that, I was numb, and then the anger and then the pain came, and the tears. It took a month before the tears came, because I saw in him what was my life with my second daughter just six months prior, begging that she can’t breathe, like, “Look at the monitor,” and I’m being told, “Her lips aren’t blue. She’s OK.” It was just so many levels of just wrong.
And is there an issue with the education system, where people aren’t, I don’t know, told the differences between different races and colors and what to look out for in vital signs? Or is it sheer ignorance? Personally, it is sheer ignorance and bias, because I’ve seen it not just in my life but also in those who are less fortunate, who actually didn’t survive, who’ve died. And it’s my duty to say something, to speak, to train, and to educate.
Kevin Pho: What are some things the health care system can do, and those on staff that you may have encountered, what are some things that they could do differently to prevent future occurrences of this?
Tomi Mitchell: I recognize that there’s implicit bias. There are biases, OK? One of the biases is that Black people don’t feel pain the same way. Well, again, one story: I had my first baby, I had a C-section, and I got the pleasure of feeling my C-section, screaming in agony for them to stop, and they continued. We feel pain. And when you do harm to somebody, it’s not just them you harm; it’s their family, potentially.
Second is to listen to them. Listen. Patients typically give us the answer to what’s going on; that’s why we take a history. And for me, I’m very forthright. I’ll be like, “A plus B plus C equals C,” like, whatever. I’ll just tell you. You don’t have to dig around. I’ll tell you all the key things you need to know, with the numbers and the stats. I’m a Rolodex. I’m a physician; I know what I’m doing. And I’ll say it with kindness and respect. So don’t see it as an ego trip. Don’t be like, “Oh, how dare she tell us what to do.” You know, no. Humble yourself and listen. Don’t be so proud and arrogant, and treat people like they’re humans.
Kevin Pho: Now, is the answer more training? Is there anywhere online, or courses, where health care staff members can educate themselves?
Tomi Mitchell: It definitely starts in training, with empathy and with recognizing in our curriculums, from an early age, elementary school, that there is bias. Don’t, quote-unquote, “whitewash” the education. It’s there. It’s in institutions. It’s in health care. It’s fact. People have spent millions of dollars proving this fact, and many of us of color have experienced it, and it’s not just coincidence if it happens repeatedly to us in certain places.
If you don’t know how to deal with it, because many people have put their head in the sand because they didn’t have the tools to deal with it, find somebody to train and to teach on inclusion. Make sure, when you’re teaching your systems in the medical schools and residency, that you are taking into consideration cultural differences and color differences. Like, by the time I show signs of anemia, I might as well be writing my own obit, or my will, and I literally did write my will in the hospital. I’m not going to be white. I’ll be pale, like, mucous membranes, and mine were my version of white.
How much more for someone who is, like, the darkest of dark, Black, almost blue, as I like to call it, because we have different specs. You can’t; you have to pay attention, and know that what is normal for one is not necessarily normal for others. If your patient tells you, “My blood pressure is normally 85 over 65,” which is mine, like, I have a very low blood pressure and a low resting heart rate, because I believe I’m in shape. So when my blood pressure goes to 130, 135, 140, and you think that’s OK, no, that’s not OK. That’s my body saying hello.
So listen to the patient when they tell you. Listen. Don’t prejudge, and think of the patient as being your mother, your sister, your wife, your brother. And that’s how I treat my patients. They’re my cubs. So I do my best to help them, and something I do not know, I find help for them.
Kevin Pho: We’re talking to Tomi Mitchell. She’s a family physician in Canada. She wrote the KevinMD article “The unique agony of being a Black female doctor.” Tomi, what are some of your take-home messages that you want to leave with the KevinMD audience?
Tomi Mitchell: Well, thank you for listening. Change needs to happen. You know, as women, take away the Black, we definitely have a challenging road ahead of us in medicine. We often, you know, aren’t the quote-unquote “leaders,” and we don’t get certain positions, for many different reasons. I’m not going to go into them, but just know we all have our biases. We all do, and I do, but let’s keep them in check.
Let’s really think: When you see somebody, what comes first to your mind? Do you think of them as being drug-seeking? “Oh, they can wait.” And when you think of someone who you need to act on right now, who do you think of? Is there a difference in care? Now, this is pre-coded, obviously. Is there a difference in how you respond to them? Can you honestly say that’s how you would want to be treated? You need to ask yourself that. The golden rule: “Do unto others as you have them do unto you.”
And studies show Black patients who are treated by Black physicians, physicians of color, have better outcomes. It’s a fact. So that representation really matters, not just color, but culturally. Having lived across this globe, and different continents, there’s a difference in how people express themselves and how they expect care to be delivered, in a very sensitive, culturally competent way. That needs to be taught.
So thank you for listening. Take the time, like, make it a priority, to learn to check your biases, because we all have them, but that should not come in the way of us giving caring, empathetic care, where, if you were that patient, you would be happy and proud of the care you’ve received. And I must say, I have received excellent care. There are places I know to go to now where I can receive excellent care. So I’m not saying I’m painting everyone the same brush, but I’m saying listen to your patients. Like, just listen and act.
Kevin Pho: Tomi, thank you so much for sharing your time, insight, and story, and thanks again for being on the show.
Tomi Mitchell: My pleasure.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
