I'm upset- implicit bias/micro aggressions

[kicks]

I was going to put this in randoms thread but decided to start a new one.

I'm so annoyed/upset.

We are rounding with the attending (2 med students and 1 other resident). They are talking about a patient (not one of my patients so I haven't seen him) complaining that he's cranky and won't let them do a full exam. Which ok I get, it is frustrating day dealing with cranky patients who won't let you do your job and I complain about that too.

But then the resident (an older white male) goes "yeah when I wake him up in the morning I think he might start swing punches." Then, the med student (a young white female) says, "yeah when I am listening to his heart i think to myself that I'm within arms reached of getting punched."

So I'm wondering why they have gone from patient being cranky to scared for their safety. I think hmm, let me see if I can look up his race.

Sure enough, the patient is a black male. So of course they are afraid for their safety :/

As I type this out, the more upset I'm getting and can't focus. This is the kind of stuff that is never going to change. You know if it were a white female patient those thoughts would not have been there. I just can't with white people anymore.

[sfy]

I'm sorry and I agree with you re this is the kind of stuff that is never going to change. And this is why I will never be on a "We are the world" kick, because it's the kinds of things most white people (sometimes subconsciously) think about the POC they don't know that will never sit right with me. Implicit bias is real.

You didn't ask for advice, but honestly, this is not a situation where I'd play a race card. The deck I use at work is getting uncomfortably low at this point . But besides that, I try to save it for the undeniable. This is too easy for them to attribute to personality (and yes, maybe it is, although I doubt it). I would, however, if those kind of remarks are made again, feel quite comfortable asking, "So what it is about him that makes you think he might be violent with you? Because cranky is one thing, but I don't typically think that all cranky patients will be physically aggressive, so has he done something to make you feel that way?" And wait. And when they give you the inevitable nonsense they are bound to give, I would respond, "Hmmm, that's interesting," with a knowing look that says, I see you.

Again, I'm sorry you have to deal with this.

[kicks]

Oct 4, 2016 11:37:26 GMT -5 sfy said:

I'm sorry and I agree with you re this is the kind of stuff that is never going to change. And this is why I will never be on a "We are the world" kick, because it's the kinds of things most white people (sometimes subconsciously) think about the POC they don't know that will never sit right with me. Implicit bias is real.

You didn't ask for advice, but honestly, this is not a situation where I'd play a race card. The deck I use at work is getting uncomfortably low at this point . But besides that, I try to save it for the undeniable. This is too easy for them to attribute to personality (and yes, maybe it is, although I doubt it). I would, however, if those kind of remarks are made again, feel quite comfortable asking, "So what it is about him that makes you think he might be violent with you? Because cranky is one thing, but I don't typically think that all cranky patients will be physically aggressive, so has he done something to make you feel that way?" And wait. And when they give you the inevitable nonsense they are bound to give, I would respond, "Hmmm, that's interesting," with a knowing look that says, I see you.

Again, I'm sorry you have to deal with this.

This is good advice.

If it were just me and the med student, I definitely would've/will use this tactic in the future.

But with the hierarchy of medicine (even though the attending on this week is really nice), I can't interrupt rounds to bring it up.

I'm talking to minority med students tomorrow so I might use this as an example of implicit bias in medicine.

[threejs]

I'm sorry. I hate these reminders and seem to keep getting them lately. Not to make it all about me, but your issue reminded me that last Friday I spent the day volunteering at a golf event fundraiser for my daughter's school. At one point 4 or 5 moms were sitting around a table chatting about DC. One mom mentions how she works in the navy yard area and how when she was growing up she was not allowed to even think about venturing into SE DC, no matter the time of day. Other moms were nodding and agreeing about how scary dangerous it was but now it's so much better and safer. I'm still mad at myself for sitting there like a dummy. Of course the area was oh so scary when it was only black, but now that white folks are there it's so great and wonderful. Again, sorry to hijack, but wanted to commiserate.

[kicks]

Oct 4, 2016 11:55:58 GMT -5 threejs said:

I'm sorry. I hate these reminders and seem to keep getting them lately. Not to make it all about me, but your issue reminded me that last Friday I spent the day volunteering at a golf event fundraiser for my daughter's school. At one point 4 or 5 moms were sitting around a table chatting about DC. One mom mentions how she works in the navy yard area and how when she was growing up she was not allowed to even think about venturing into SE DC, no matter the time of day. Other moms were nodding and agreeing about how scary dangerous it was but now it's so much better and safer. I'm still mad at myself for sitting there like a dummy. Of course the area was oh so scary when it was only black, but now that white folks are there it's so great and wonderful. Again, sorry to hijack, but wanted to commiserate.

No thank you for sharing. That's why I started a new thread and didn't put it in randoms. I know we all have examples and need to vent or get advice on how to navigate them.

I always hate the talks about neighborhood safety, or the "ghetto" Ugh.

These kind of examples happen regularly and not only is it annoying and upsetting but it wears on your psyche. At least that's how I've felt lately.

[fryjack2]

I'm sorry kicks.

Its tough to navigate in the world of medicine. Especially when its still somewhat of a white boys club.

A couple years ago, I was rounding with an pretty senior attending that got paged for a new consult in the ER. He rolled his eyes and said something like, "Another Middle Eastern consult. I can save them a bunch of time and just tell them their issues are because they are consanguineous." I was stunned. I had a good relationship with him so I said, "Hey Dr. X! I'm Middle Eastern and my parents aren't related! Not every Arab is." I tried to be light hearted and joke about it because I wasn't sure how to navigate his comment in front of a bunch of people. I almost didn't say anything at all. If it was a different attending, I may not have

I like your thought of bringing it up when talking to med students later. I truly feel more cultural awareness training needs to be part of the curriculum.

[andwhat]

I'm so sorry. I deal this this kind of stuff on a regular basis. I was pleasantly surprised today when my job listed that they were starting a focus group on how to increase equity, diversity, and inclusion. Of course I submitted for it immediately. I mean this almost guarantees that I won't get picked because I really care about this issue, but the fact that they are even doing it is a huge step.

We will see what comes out of it.

[redwino]

I'm sorry kicks. Work situations are always tough. I'm finding myself taking babysteps in confronting microagressions but I'm still letting a lot of stuff slide because I'm not quick enough to come back with a good response or I just feel like it's not worth it. Yesterday I managed to ask a coworker, "say what now?" after she made a comment about the Eastside which is the black side of town. I thought about asking her exactly what she meant but decided I didn't have time to get into it with her because I was running late for daycare. Part of me feels like I should have stayed and gone further with her but the other part of me is like, it's not worth it. It's so frustrating.

[kicks]

I'm revisiting this because the referenced patient in this post is now my patient to see and I saw him for the first time this morning.

I went in with an open mind that maybe he would be aggressive and their comments were somewhat justified.

Nope, he wasn't very cooperative, in that I didn't exam him. But he was very mild mannered and non threatening.

The only reason they said those comments is because he is a black male.

[andwhat]

well that update makes me sad kicks. How can you treat patients if you are unjustly afraid of them?

[thejackpot]

Oh kicks, your update is so disheartening. Part of the reason I seek out physians of color for my kids is because I want them to see doctors who look more like them I really hadn't thought about this aspect. Ugh. Just awful.

[lovelyshoes]

That's so messed up. I feel so bad for this poor man.