“You have to show proof that you have something wrong with you in order for you to get the medicine. I put forth, and I maintain that if I was white, I wouldn’t have to go through that.”
– Dr. Susan Moore.

In a 7-minute-and-22-second Facebook video documenting her treatment at a suburban hospital in Indiana, Dr. Susan Moore, a Black woman physician, articulated the collective desperation and frustration that was a direct result of what she and many Black people have experienced as patients. She was hospitalized for and ultimately succumbed to complications of COVID-19 on December 22, 2020. She alleged that she was mistreated and mismanaged and that the root of these acts was racism.

December 22, 2021, marked a painful anniversary and serves as a reminder that this experience she documented and shared to educate others of the lack of deferential treatment she received played a role in her demise.

This sad and familiar story that Dr. Moore told of her initial hospitalization exemplifies a reality that absolutely needs to be deconstructed, examined, assessed, and understood as rigorously as the knowledge of basic and clinical science is prioritized during our medical school education and throughout our career as physicians.

The import of her experience, and the systemic, institutional, and interpersonal racism entrenched in it, is one we cannot excuse as an isolated circumstance of a disgruntled patient. To do so unequivocally continues to perpetuate a system of racism that is literally killing Black people.

The sequelae of this system that many underrepresented minorities in medicine have long observed, lived through and worked to counter for professional and personal survival has, finally and formally, been deemed a public health crisis by several U.S. state and city authorities and organizations such as the American Medical Association.

But what does this actually mean for patients like Dr. Susan Moore?

Even with a medical degree that empowers her with the specialized knowledge to advocate for herself in a way that most patients cannot, she was not afforded the equal respect and treatment that others of a lighter shade are given without question nor hesitation.

During her video narrative, she explains how, during her stay, she is consistently met with skepticism, disbelief, and disdain. Despite published literature showing disparities in care and harmful interactions that perpetuate negative outcomes for Black patients, this
damaging history in the field of medicine continues to repeat itself.

When we see social inequities in health in Black populations, we all must accept the reality that this is absolutely not a coincidence or secondary to individual irresponsibility. We must accept that this was not a result of Black people’s own making. We must accept that there is not some underlying biological or genetic justification for why poorer outcomes exist for Black persons for so many chronic conditions and now with mortality related to COVID-19.

We must accept that these outcomes do not occur because of a patient’s medical complexities or because the patient’s medical knowledge deems them threatening or intimidating to her care team, as the president and CEO of Indiana University Health purported in
a press release about Dr. Moore’s ordeal in 2020 at his hospital. More simply and accurately, we must accept that racism is the cause.

As Dr. Moore plainly stated, “This is how Black people get killed.” The stark inequity we have witnessed with COVID-19 hospitalizations and deaths of Black people is an inevitability. When we look at the social determinants of health that place certain races and ethnicities in an advantaged position, and Black people, especially Black women, on the opposing end of such advantages, the disparity is no surprise.

As academic institutions that are tasked with teaching future physicians and future leaders in medicine, I fear we are falling short. If we fail to rigorously teach and hone our skills in cultural competency and equip physicians with the knowledge of the history of racism in medicine, we inch closer to health equity for all patients.

Dr. Susan Moore’s racial battle fatigue was clear and evident during her public chronicle of her suffering from her hospital bed. This fatigue that serves as an anchor professionally and personally can seem insurmountable when one is physically sick and in need of medical attention and decency.

Because of her video, we are all bystanders to how intersectional discrimination plagues Black women. In a speech delivered in 1962, Malcolm X famously stated, “The most disrespected person in America is the [B]lack woman. The most unprotected person in America is the [B]lack woman. The most neglected person in America is the [B]lack woman.”

Dr. Moore deserved so much better.

As Black physicians passionate about the work diversity and inclusion requires, we can only summon so many calls to action. For all in the field of medicine, we cannot continue to sacrifice lives for the sake of those in the majority of medicine’s comfort and fragility.

If we as an institution of medicine are in the business of caring for Black patients equitably, we need more practicing Black physicians, and we need more Black physicians in leadership positions.

As a Black woman physician in a specialized field of medicine where the number of those who look like me is sparse, I have heard versions of Dr. Moore’s narrative when speaking with Black patients who divulge these kinds of patient experiences to me because they feel there is a connection forged that allows them to feel safe and believed.

When we think of who will save those like Dr. Moore, a mother, a daughter, and at the core, a human being looking for compassion and respect, we should be able to look to anybody entrusted to care for patients answer that call. But more openly and publicly, we find that we cannot entrust just anybody to save us.

There is a living legacy and unique lived experience that informs many Black patients’ distrust for medicine as an institution that goes beyond a general fear or suspicion that must be acknowledged and understood so that more of these stories like Dr. Moore’s do not become so commonplace that we become numb to them.

At our worst, we continue to accept them. Let the words of our colleague, Dr. Susan Moore, be the stinging reminder that we have so much more actual, actionable steps to take to go beyond the performative rejection of racism in medicine currently being so well-advertised. We cannot just continue to hope for better. We must actually be better.

Sophie M. Balzora is a gastroenterologist and can be reached on Twitter @SophieBalzoraMD.

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